Active NPI
Gallery of Eyewear, LLC
- Optician
- Everett, WA
National Provider Identifier
1548287303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- D00757
- Legal business name
- GALLERY OF EYEWEAR, LLC
- Practice address
- 3930 Hoyt Ave
Everett, WA 98201-4919 - Phone
- (425) 551-5195
- Fax
- (425) 259-2801
- NPI assigned
- Jul 17, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Lori M Moses
- Title
- Bookkeeper
- Phone
- (425) 551-5195
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | D00757 | WA | Primary |
Addresses
Primary practice location
3930 Hoyt Ave
Everett, WA 98201-4919
Mailing address
3930 Hoyt Ave
Everett, WA 98201-4919
Phone (425) 551-5195
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930008274 | WA | DME Supplier - Physician - Ophthalmology | 9638297591 | Practice locations: Everett, WA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Ophthalmology Physician
- Everett, WA
- NPI 1154345684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1548287303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3930 HOYT AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014919",
"telephone_number": "425-551-5195",
"fax_number": "425-259-2801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3930 HOYT AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014919",
"telephone_number": "425-551-5195",
"fax_number": "425-259-2801"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GALLERY OF EYEWEAR, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-17",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MOSES",
"authorized_official_first_name": "LORI",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "BOOKKEEPER",
"authorized_official_telephone_number": "425-551-5195",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "WA",
"license": "D00757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Everett, WA
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.