Individual provider Active NPI

Paula Suzanne Fadhl-Pohl, O.D.

  • Optometrist
  • Seattle, WA
National Provider Identifier
1720092588
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3891TX Issued in WA
Practice address
2025 1St Ave
Suite C
Seattle, WA 98121
Phone
(206) 443-0320
Fax
(206) 443-0323
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 00003891TX WA
Optometrist 152W00000X 3891TX WA Primary

Addresses

Primary practice location

2025 1St Ave
Suite C
Seattle, WA 98121

Mailing address

2025 1St Ave
Suite C
Seattle, WA 98121
Phone (206) 443-0320

Other identifiers 1

IdentifierTypeStateIssuer
2031193MedicaidWA

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
I20050324000465 WA Practitioner - Optometry 1355397134

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10032 Main St
Bellevue, WA 98004-6024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00003891TXWAMDOptometrist
3891TXWAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Murray Scholls Optique Inc Optometrist PastSince Apr 19, 2011 Accepting new patients

Organizations & group practices 2

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1720092588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 1ST AVE",
            "address_2": "SUITE C",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98121",
            "telephone_number": "206-443-0320",
            "fax_number": "206-443-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 1ST AVE",
            "address_2": "SUITE C",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98121",
            "telephone_number": "206-443-0320",
            "fax_number": "206-443-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADHL-POHL",
        "first_name": "PAULA",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "00003891TX",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3891TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2031193",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.