Individual provider Active NPI

Earl Mark Ryder, OD

  • Optometrist
  • Spokane, WA
National Provider Identifier
1700879335
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001673 Issued in WA
Practice address
400 E 5TH Ave
Spokane, WA 99202
Phone
(509) 838-2531
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00001673 WA Primary

Addresses

Primary practice location

400 E 5TH Ave
Spokane, WA 99202

Mailing address

PO Box 3649
Spokane, WA 99220-3649

Other identifiers 1

IdentifierTypeStateIssuer
2009850MedicaidWA

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
I20040709000548 WA Practitioner - Optometry 3577541275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

300 E 5TH Ave
Spokane, WA 99202-1334

311 S L St
Tacoma, WA 98405-3720

400 E 5TH Ave
Spokane, WA 99202-1334
Phone (509) 838-2531

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Fred Meyer Stores Inc. Past Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

842 S Cowley St
Spokane, WA 99202
Phone (509) 465-8885

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 5

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1700879335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3649",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99202",
            "telephone_number": "509-838-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDER",
        "first_name": "EARL",
        "middle_name": "MARK",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2009850",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.