Dr. William Balogh

Primary specialty

OptometristTaxonomy code 152W00000X

License

O.D.00001030 Issued in WA

Legal business name

DR. WILLIAM BALOGH

Practice address

2016 S 320TH St
Suite E
Federal Way, WA 98003-5453

Phone

(253) 839-1610

Fax

(253) 839-0755

NPI assigned

Nov 22, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Maria L Burgos

Title

Office Manager

Phone

(253) 839-1610

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• CENTER PLAZA VISION CLINIC Other name

Tax ID family

Binyon Optometrists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• William Balogh

  • Optometrist
  • Tacoma, WA
  • NPI 1871667964
  NPD tax ID

Locations

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417022484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 S 320TH ST",
            "address_2": "SUITE E",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035453",
            "telephone_number": "253-839-1610",
            "fax_number": "253-839-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S 320TH ST",
            "address_2": "SUITE E",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035453",
            "telephone_number": "253-839-1610",
            "fax_number": "253-839-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. WILLIAM BALOGH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURGOS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "253-839-1610",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "O.D.00001030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBN",
            "identifier": "WA0006",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "3909",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "BA3096",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "02781",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2052900",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "212835",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "44132B",
            "identifier": "AETNA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTER PLAZA VISION CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Optometrist in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.