Active NPI
Robert V Glaze, OD
- Optometrist
- Bellevue, WA
National Provider Identifier
1386639490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- WA1288
- Practice address
- 13401 Bel Red Rd
Ste A4
Bellevue, WA 98005-2322 - Phone
- (425) 747-2020
- Fax
- (425) 747-2099
- NPI assigned
- Sep 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | WA1288 | WA | Primary |
Addresses
Primary practice location
13401 Bel Red Rd
Ste A4
Bellevue, WA 98005-2322
Mailing address
13401 Bel Red Rd
Ste A4
Bellevue, WA 98005-2322
Phone (425) 747-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GL0422 | Other | WA | REGENE BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WA1288 | WA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196294400000",
"number": "1386639490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13401 BEL RED RD",
"address_2": "STE A4",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980052322",
"telephone_number": "425-747-2020",
"fax_number": "425-747-2099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13401 BEL RED RD",
"address_2": "STE A4",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980052322",
"telephone_number": "425-747-2020",
"fax_number": "425-747-2099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLAZE",
"first_name": "ROBERT",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2007-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "WA1288",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENE BLUE SHIELD",
"identifier": "GL0422",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.