Individual provider Active NPI

Jonathan Charles Ashbaker, OD

  • Optometrist
  • Vancouver, WA
National Provider Identifier
1639152580
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD 3779 Issued in WA
Practice address
8217 E Mill Plain Blvd
Vancouver, WA 98664-2004
Phone
(360) 695-3829
Fax
(360) 695-7718
NPI assigned
Nov 23, 2005
Last updated
Jan 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD 3779 WA Primary

Addresses

Primary practice location

8217 E Mill Plain Blvd
Vancouver, WA 98664-2004

Mailing address

8217 E Mill Plain Blvd
Vancouver, WA 98664-2004
Phone (360) 695-3829

Other identifiers 1

IdentifierTypeStateIssuer
2027217MedicaidWA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101228000676 WA Practitioner - Optometry 6103818885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8217 E Mill Plain Blvd
Vancouver, WA 98664-2004
Phone (360) 695-3829

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD 3779WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ashbaker Vision Clinic Inc Optometrist CurrentSince Oct 31, 2002 Accepting new patients

Locations

8217 E Mill Plain Blvd
Vancouver, WA 98664
Phone (360) 695-3829

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.

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1639152580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8217 E MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986642004",
            "telephone_number": "360-695-3829",
            "fax_number": "360-695-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8217 E MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986642004",
            "telephone_number": "360-695-3829",
            "fax_number": "360-695-7718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHBAKER",
        "first_name": "JONATHAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 3779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2027217",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.