Individual provider Active NPI

Shailka Dawar, O.D

  • Optometrist
  • Kent, WA
National Provider Identifier
1700327871
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
61162929 Issued in WA
Practice address
10002 SE 240TH St
Kent, WA 98031-4839
Phone
(206) 406-8003
NPI assigned
Mar 9, 2017
Last updated
Jun 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00672300 NJ
Optometrist 152W00000X 61162929 WA Primary
Optometrist 152W00000X 34450 CA

Addresses

Primary practice location

10002 SE 240TH St
Kent, WA 98031-4839

Mailing address

10002 SE 240TH St
Kent, WA 98031-4839
Phone (206) 406-8003

Other practice location 1

509 Stillwells Corner Rd Ste E5
Freehold, NJ 07728
Phone (732) 431-9333

Other practice location 2

15923 Bear Valley Rd Ste B100
Hesperia, CA 92345-1762
Phone (760) 949-6363

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
I20220429001157 WA Practitioner - Optometry 9830463975 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00672300NJMDOptometrist
61162929WAMDOptometrist
34450CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis S Lim and Associates OD PS Optometrist CurrentSince Jun 1, 2023 Accepting new patients
Vision Express Optometry, Inc. Optometrist CurrentSince Apr 1, 2020 Accepting new patients
Michael H Chow & Associates PLLC Optometrist PastSince Jul 17, 2021 Accepting new patients
Kirkland Vision Center, LLC Optometrist PastSince Jun 1, 2023 Accepting new patients

Locations

15923 Bear Valley Rd
Ste B100
Hesperia, CA 92345
Phone (760) 949-6363

10024 SE 240th St
Ste 220
Kent, WA 98031
Phone (253) 852-5440

Interoperability endpoints

  • FHIR API: https://icareopticalofkent.ef.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 4

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": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1700327871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10002 SE 240TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980314839",
            "telephone_number": "206-406-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10002 SE 240TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980314839",
            "telephone_number": "206-406-8003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 Stillwells Corner Rd Ste E5",
            "address_purpose": "LOCATION",
            "city": "Freehold",
            "state": "NJ",
            "postal_code": "07728",
            "country_code": "US",
            "telephone_number": "732-431-9333",
            "fax_number": "732-431-3312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15923 Bear Valley Rd Ste B100",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923451762",
            "country_code": "US",
            "telephone_number": "760-949-6363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWAR",
        "first_name": "SHAILKA",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00672300",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "61162929",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.