Individual provider Active NPI

Michael L Giese, OD

  • Optometrist
  • Seattle, WA
National Provider Identifier
1639366354
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00004085 Issued in WA
Practice address
10416 5TH Ave NE
Seattle, WA 98125
Phone
(206) 517-6700
NPI assigned
Sep 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00004085 WA Primary

Addresses

Primary practice location

10416 5TH Ave NE
Seattle, WA 98125

Mailing address

10416 5TH Ave NE
Seattle, WA 98125-7402
Phone (206) 517-6700

Other practice location 1

10330 Meridian Ave N
Suite 370
Seattle, WA 98133-9451
Phone (206) 528-6000

Other practice location 2

10330 Meridian Ave N
Suite 370
Seattle, WA 98133-9451
Phone (206) 528-6000

Other practice location 3

1909 214th St SE Ste 300
Bothell, WA 98021-4418
Phone (425) 412-7200

Other identifiers 1

IdentifierTypeStateIssuer
OD00004085OtherWAMEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgiese1042846@wm.providencedirect.org Direct

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
I20071015000273 WA Practitioner - Optometry 3072609585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

10416 5TH Ave NE
Seattle, WA 98125-7402
Phone (206) 517-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics CurrentSince Nov 3, 2017 Accepting new patients
Pacmed Clinics Current Accepting new patients
Pacmed Clinics CurrentSince Nov 3, 2017 Accepting new patients

Locations

1909 214th St SE
Ste 300
Bothell, WA 98021
Phone (425) 412-6335

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

1412 SW 43rd St
Ste 310
Renton, WA 98057
Phone (425) 235-1200

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

10416 5th Ave NE
Seattle, WA 98125
Phone (206) 517-6667

Organizations & group practices 3

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": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1639366354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10416 5TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257402",
            "telephone_number": "206-517-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10416 5TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98125",
            "telephone_number": "206-517-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10330 Meridian Ave N",
            "address_2": "Suite 370",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981339451",
            "country_code": "US",
            "telephone_number": "206-528-6000",
            "fax_number": "206-528-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10330 Meridian Ave N",
            "address_2": "Suite 370",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981339451",
            "country_code": "US",
            "telephone_number": "206-528-6000",
            "fax_number": "206-528-0014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1909 214th St SE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980214418",
            "country_code": "US",
            "telephone_number": "425-412-7200",
            "fax_number": "425-412-7350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIESE",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00004085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OD00004085",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgiese1042846@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1909 214th St SE Ste 300",
            "city": "Bothell",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980214418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.