Jon Tyler Conner, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1817TX Issued in IN

Practice address

1801 NW Market St
Ste 107
Seattle, WA 98107-3909

Phone

(206) 783-3828

Fax

(206) 789-2261

NPI assigned

Apr 13, 2007

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• First Hill Vision and Ballard Eye Physicians

  • Optometrist
  • Seattle, WA
  • NPI 1528281813
  NPD (past) Authorized official

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1487879714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 NW MARKET ST",
            "address_2": "STE 107",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073909",
            "telephone_number": "206-324-2006",
            "fax_number": "206-223-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NW MARKET ST",
            "address_2": "STE 107",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073909",
            "telephone_number": "206-783-3828",
            "fax_number": "206-789-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "JON",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "1817TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2008829",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randy James Connelly
• Taryn Lilly Connelly, RN, BSN
• Daphne S. Conner, L.M.P.
• Emily Louise Conner, MS, RD, CD
• Frederick Conner, CDP
• Caitlin Connolly
• Daniel David Connolly, PHARMACIST
• Janice M. Connolly, MD
• Kailey E Connolly, PT, DPT
• Luke Christopher Connolly

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.