Active NPI
Gregory Thomas Sankey
- Ocularist
- Seattle, WA
National Provider Identifier
1700995461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ocularist
- License
- OS00000012
- Practice address
- 10212 5TH Ave NE
Suite 210
Seattle, WA 98125-7452 - Phone
- (206) 522-4222
- Fax
- (206) 525-1496
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ocularist | 156FX1700X | OS00000012 | WA | Primary |
Addresses
Primary practice location
10212 5TH Ave NE
Suite 210
Seattle, WA 98125-7452
Mailing address
10212 5TH Ave NE
Suite 210
Seattle, WA 98125-7452
Phone (206) 522-4222
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37189 | Other | WA | LABOR & INDUSTRY PROVIDER |
| PO4547 | Medicaid | AK | |
| 344581001 | Other | WA | GROUP HEALTH COOP |
| PO45471 | Other | AK | ALASKA MEDICAID # |
| 9033929 | Medicaid | WA | |
| 911508025 | Other | WA | FEDERAL TAX ID# |
| 8917595 | Other | WA | CRIME VICTIMS |
| CU0117 | Other | WA | REGENCE PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930052008 | WA | DME Supplier - Ocularist | 9739207564 | Practice locations: Seattle, WA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS00000012 | WA | MD | Ocularist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Custom Ocular Prosthetics LLC | Ocularist | Current | Accepting new patients |
Locations
10212 5th Ave NE
Ste 210
Seattle, WA 98125
Phone (206) 522-4222
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": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1700995461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10212 5TH AVE NE",
"address_2": "SUITE 210",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981257452",
"telephone_number": "206-522-4222",
"fax_number": "206-525-1496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10212 5TH AVE NE",
"address_2": "SUITE 210",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981257452",
"telephone_number": "206-522-4222",
"fax_number": "206-525-1496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANKEY",
"first_name": "GREGORY",
"middle_name": "THOMAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1700X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ocularist",
"state": "WA",
"license": "OS00000012",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY PROVIDER",
"identifier": "37189",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PO4547",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH COOP",
"identifier": "344581001",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALASKA MEDICAID #",
"identifier": "PO45471",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9033929",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID#",
"identifier": "911508025",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8917595",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE PROVIDER #",
"identifier": "CU0117",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.