Individual provider Active NPI

Jenni Rubio Aaseby, O.D.

  • Optometrist
  • Shelton, WA
National Provider Identifier
1720133374
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003984 Issued in WA
Practice address
1701 N 13TH St
Shelton, WA 98584-2077
Phone
(360) 426-2653
NPI assigned
Jan 24, 2007
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00003984 WA Primary

Addresses

Primary practice location

1701 N 13TH St
Shelton, WA 98584-2077

Mailing address

PO Box 1668
Shelton, WA 98584-5001
Phone (604) 262-6533

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
I20051219000480 WA Practitioner - Optometry 0648291633 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 1 of Mason County CurrentSince Apr 16, 2012 Accepting new patients
Hawks Prairie Vision Clinic, P.S. CurrentSince Aug 16, 2018 Accepting new patients
Teresa a E Wills OD Optometrist PastSince May 1, 2009 Accepting new patients

Locations

2539 Marvin Rd NE
Ste B
Lacey, WA 98516
Phone (360) 459-3333

1701 N 13th St
Shelton, WA 98584
Phone (360) 426-2653

2300 Kati Ct
Ste C
Shelton, WA 98584
Phone (360) 426-0955

901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611

Organizations & group practices 3

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1720133374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1668",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985845001",
            "telephone_number": "604-262-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N 13TH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842077",
            "telephone_number": "360-426-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AASEBY",
        "first_name": "JENNI",
        "middle_name": "RUBIO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

Verify at the official NPI Registry.