Individual provider Active NPI

Zachary German, O.D.

  • Optometrist
  • Tumwater, WA
National Provider Identifier
1720640246
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61189395 Issued in WA
Practice address
5164 Capitol Blvd SE
Tumwater, WA 98501-4442
Phone
(360) 357-3410
NPI assigned
Jul 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3548 TN
Optometrist 152W00000X 2457 AZ
Optometrist 152W00000X OD61189395 WA Primary

Addresses

Primary practice location

5164 Capitol Blvd SE
Tumwater, WA 98501-4442

Mailing address

2845 N Prescott Rd
Flagstaff, AZ 86001-1077
Phone (937) 776-8139

Other practice location 1

4650 N US Highway 89 Ste C2
Flagstaff, AZ 86004-2444
Phone (928) 522-8424

Other identifiers 1

IdentifierTypeStateIssuer
OD61189395OtherWAWA STATE OD LICENSE

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
I20210827002641 WA Practitioner - Optometry 6103256532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Health PLLCGroup PAC ID 3072612779, 5 clinicians

Practice addresses (Care Compare)

5164 Capitol Blvd SE
Tumwater, WA 98501-4442
Phone (360) 357-3410

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2457AZMDOptometrist
OD61189395WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Health PLLC Optometrist CurrentSince Aug 18, 2021 Accepting new patients
Southern College of Optometry Optometrist PastSince Mar 21, 2020 Accepting new patients

Locations

5164 Capitol Blvd SE
Tumwater, WA 98501
Phone (360) 357-3410

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1720640246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 N PRESCOTT RD",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011077",
            "telephone_number": "937-776-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5164 CAPITOL BLVD SE",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985014442",
            "telephone_number": "360-357-3410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 N US Highway 89 Ste C2",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860042444",
            "country_code": "US",
            "telephone_number": "928-522-8424",
            "fax_number": "928-526-1503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERMAN",
        "first_name": "ZACHARY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-04",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3548",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2457",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61189395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE OD LICENSE",
            "identifier": "OD61189395",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tumwater, WA

Sources for this page

Verify at the official NPI Registry.