Michael Patrick Woods, O. D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001321 Issued in WA

Practice address

915 Vintage Valley Parkway
Suite 100
Zillah, WA 98953

Phone

(509) 865-2777

Fax

(509) 865-4021

NPI assigned

Jan 16, 2007

Last updated

Jun 11, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aeg Washington Professional PC

  • Optometrist
  • Bellevue, WA
  • NPI 1134835176
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1417008178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 VINTAGE VALLEY PARKWAY",
            "address_2": "SUITE 100",
            "city": "ZILLAH",
            "state": "WA",
            "postal_code": "98953",
            "telephone_number": "509-865-2777",
            "fax_number": "509-865-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 VINTAGE VALLEY PARKWAY",
            "address_2": "SUITE 100",
            "city": "ZILLAH",
            "state": "WA",
            "postal_code": "98953",
            "telephone_number": "509-865-2777",
            "fax_number": "509-865-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2028918",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Douglas Stafford, D.D.S.
• Total Renal Care Inc (Zillah Dialysis)
• Leanea Margaret Villafan
• Raul Juan Villarruel, LMP
• Vintage Valley Pharmacy LLC (Doctor's Pharmacy)
• Phylicia Danielle Yorgure, M.D.
• Zillah Chiropractic Center Inc PS
• Zillah Drug Store Inc (Zillah Drug Store)
• Zillah School District
• Zillah Vision PLLC

• Optometrist in Zillah, WA
• Providers in Zillah, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.