Individual provider Active NPI

Mark H Cohn, O.D.

  • Optometrist
  • Bellevue, WA
National Provider Identifier
1407856735
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001034 Issued in WA
Practice address
15650 NE 24TH St
Suite B
Bellevue, WA 98008-2460
Phone
(425) 746-9914
Fax
(425) 746-9916
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00001034 WA Primary

Addresses

Primary practice location

15650 NE 24TH St
Suite B
Bellevue, WA 98008-2460

Mailing address

15650 NE 24TH St
Suite B
Bellevue, WA 98008-2460
Phone (425) 746-9914

Other identifiers 1

IdentifierTypeStateIssuer
2013423MedicaidWA

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

LicenseStateTypeSpecialty
OD00001034WAMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1407856735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15650 NE 24TH ST",
            "address_2": "SUITE B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980082460",
            "telephone_number": "425-746-9914",
            "fax_number": "425-746-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15650 NE 24TH ST",
            "address_2": "SUITE B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980082460",
            "telephone_number": "425-746-9914",
            "fax_number": "425-746-9916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHN",
        "first_name": "MARK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013423",
            "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 Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.