Active NPI
Scott Mark Seaburg, O.D.
- Optometrist
- Chicago, IL
National Provider Identifier
1437508587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046011016
- Practice address
- 645 N Michigan Ave
Ste. 210
Chicago, IL 60611-2826 - Phone
- (312) 787-2020
- NPI assigned
- Jun 9, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046011016 | IL | Primary |
| Optometrist | 152W00000X | OD60643254 | WA |
Addresses
Primary practice location
645 N Michigan Ave
Ste. 210
Chicago, IL 60611-2826
Mailing address
645 N Michigan Ave
Ste. 210
Chicago, IL 60611-2826
Phone (312) 787-2020
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 |
|---|---|---|---|
| OD60643254 | WA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Eyecare Associates, PLLC | Optometrist | Current | Accepting new patients |
| Enumclaw Vision Clinic PLLC | Optometrist | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Seattle, WA
- NPI 1891380507
-
- Optometrist
- Enumclaw, WA
- NPI 1043718257
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465603200000",
"number": "1437508587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "645 N MICHIGAN AVE",
"address_2": "STE. 210",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112826",
"telephone_number": "312-787-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 N MICHIGAN AVE",
"address_2": "STE. 210",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112826",
"telephone_number": "312-787-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEABURG",
"first_name": "SCOTT",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-09",
"last_updated": "2016-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046011016",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD60643254",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.