Mark A Seaburg, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001260 Issued in WA

Practice address

2823 Griffin Ave
Enumclaw, WA 98022-2322

Phone

(360) 825-1614

Fax

(360) 825-8034

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Washington Professional PCGroup PAC ID 3476927997, 61 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Washington Professional PC

  • Optometrist
  • Bellevue, WA
  • NPI 1134835176
  Medicare reassignment Care Compare group NPD
• Enumclaw Vision Clinic PLLC

  • Optometrist
  • Enumclaw, WA
  • NPI 1043718257
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1720195910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 GRIFFIN AVE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222322",
            "telephone_number": "360-825-1614",
            "fax_number": "360-825-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 GRIFFIN AVE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222322",
            "telephone_number": "360-825-1614",
            "fax_number": "360-825-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEABURG",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2033207",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ernest Emmett Scholl
• Scott C Decker, DMD, PLLC
• Kera Shvonne Scott, PTA
• Rebekah Ruth Scribner, R.PH
• Drew Karl Seabrands, DC
• Sean Monaghan DMD PLLC
• Senior Care Specialists LLC
• Kelly Melissa Sennott, COTA
• Alexander Shepherd, OD
• Paul Shepherd, O.D.

• Optometrist in Enumclaw, WA
• Providers in Enumclaw, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.