Active NPI
Richard A Jensen, OD
- Optometrist
- Seattle, WA
National Provider Identifier
1447313234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD00001958
- Practice address
- 1100 9TH Ave
Ms C4-Opt
Seattle, WA 98101-2756 - Phone
- (206) 223-6840
- Fax
- (206) 515-5886
- NPI assigned
- Dec 19, 2006
- Last updated
- May 15, 2008
- 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 | OD00001958 | WA | Primary |
Addresses
Primary practice location
1100 9TH Ave
Ms C4-Opt
Seattle, WA 98101-2756
Mailing address
1100 Olive Way
Ms M4-PA
Seattle, WA 98101-1873
Phone (206) 515-5811
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00395658 | Other | WA | RAILROAD MC# |
| US7327863 | Other | WA | AETNA PCP PIN |
| 5262JE | Other | WA | BLUE SHIELD # |
| 2033116 | Medicaid | WA |
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 |
|---|---|---|---|
| OD00001958 | WA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Mason Medical Center | Past | Accepting new patients |
Interoperability endpoints
- richard.jensen@direct.vmmc.org
Organizations & group practices 1
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.
-
dba Virginia Mason LINDEMAN PAVILION PHARMACY
- Clinic Pharmacy
- Seattle, WA
- NPI 1700880291
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210809600000",
"number": "1447313234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 OLIVE WAY",
"address_2": "MS M4-PA",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981011873",
"telephone_number": "206-515-5811",
"fax_number": "206-515-5886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"address_2": "MS C4-OPT",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-223-6840",
"fax_number": "206-515-5886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "RICHARD",
"middle_name": "A",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2008-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD00001958",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MC#",
"identifier": "P00395658",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PCP PIN",
"identifier": "US7327863",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD #",
"identifier": "5262JE",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2033116",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.