Active NPI
Paul H. Min, O.D.
- Optometrist
- Shoreline, WA
National Provider Identifier
1780743823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- WA 1937
- Practice address
- 14926 Aurora Ave N
Shoreline, WA 98133-6554 - Phone
- (206) 364-6000
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | WA 1937 | WA | Primary |
Addresses
Primary practice location
14926 Aurora Ave N
Shoreline, WA 98133-6554
Mailing address
14926 Aurora Ave N
Shoreline, WA 98133-6554
Phone (206) 364-6000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MI0012 | Other | WA | REGENCE |
| 2016681 | Medicaid | WA | |
| A827335 | Other | WA | PREMERA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WA 1937 | WA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780743823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14926 AURORA AVE N",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981336554",
"telephone_number": "206-364-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14926 AURORA AVE N",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981336554",
"telephone_number": "206-364-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIN",
"first_name": "PAUL",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "WA 1937",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "MI0012",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2016681",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMERA",
"identifier": "A827335",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shoreline, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.