Individual provider Active NPI

Parisa Ghambari, OD

  • Optometrist
  • Everett, WA
National Provider Identifier
1588485288
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61618227 Issued in WA
Practice address
1130 SE Everett Mall Way Ste F
Everett, WA 98208-2800
Phone
(425) 551-1021
NPI assigned
Oct 24, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OD61618227 WA Primary

Addresses

Primary practice location

1130 SE Everett Mall Way Ste F
Everett, WA 98208-2800

Mailing address

1130 SE Everett Mall Way Ste F
Everett, WA 98208-2800
Phone (425) 551-1021

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OD61618227WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision Inc Optometrist CurrentSince Nov 3, 2024 Accepting new patients

Locations

1130 SE Everett Mall Way
Ste F
Everett, WA 98208
Phone (425) 551-1021

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1588485288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 SE EVERETT MALL WAY STE F",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082800",
            "telephone_number": "425-551-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 SE EVERETT MALL WAY STE F",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082800",
            "telephone_number": "425-551-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAMBARI",
        "first_name": "PARISA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61618227",
            "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 Dec 5, 2024; 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.