Individual provider Active NPI

Mohammad Alzeir, OD

  • Optometrist
  • Everett, WA
National Provider Identifier
1750006409
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61360943 Issued in WA
Practice address
305 SE Everett Mall Way
Everett, WA 98208-3250
Phone
(425) 386-8428
NPI assigned
Oct 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD61360943 WA Primary

Addresses

Primary practice location

305 SE Everett Mall Way
Everett, WA 98208-3250

Mailing address

16218 22ND Ave W
Lynnwood, WA 98087-2506

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
I20231012003328 WA Practitioner - Optometry 9436504347 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Wave Eye Doctors Professional Limited Liability Company CurrentSince Aug 29, 2023 Accepting new patients
Blue Wave Eye Doctors Professional Limited Liability Company Optometrist CurrentSince Aug 29, 2023 Accepting new patients

Locations

305 SE Everett Mall Way
Ste 21
Everett, WA 98208
Phone (425) 267-0575

921 N 10th St
Ste B
Renton, WA 98057
Phone (425) 255-1022

Interoperability endpoints

  • Direct secure messaging: 114175@visionworks.emadirect.md

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": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1750006409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16218 22ND AVE W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980872506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SE EVERETT MALL WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982083250",
            "telephone_number": "425-386-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALZEIR",
        "first_name": "MOHAMMAD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61360943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.