Individual provider Active NPI

Steven La, O.D.

  • Optometrist
  • Shelton, WA
National Provider Identifier
1679838874
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD 60292781 Issued in WA
Practice address
100 E Wallace Kneeland Blvd
Shelton, WA 98584-2981
Phone
(360) 427-8324
NPI assigned
Jul 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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 60292781 WA Primary

Addresses

Primary practice location

100 E Wallace Kneeland Blvd
Shelton, WA 98584-2981

Mailing address

100 E Wallace Kneeland Blvd
Shelton, WA 98584-2981
Phone (360) 427-8324

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
I20121015000463 WA Practitioner - Optometry 2668622374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 E Wallace Kneeland Blvd
Shelton, WA 98584-2981
Phone (360) 427-8324

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD 60292781WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shelton Family Eye Care, LLC Optometrist CurrentSince Sep 4, 2012 Accepting new patients

Locations

100 E Wallace Kneeland Blvd
Shelton, WA 98584
Phone (360) 427-0171

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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1679838874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E WALLACE KNEELAND BLVD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842981",
            "telephone_number": "360-427-8324",
            "fax_number": "360-427-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E WALLACE KNEELAND BLVD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842981",
            "telephone_number": "360-427-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 60292781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

Verify at the official NPI Registry.