Jasdeep Sidhu, O.D.
Individual provider Active NPI Optometrist · Stanwood, WA
NPI 1780912170 · NPPES record last updated Mar 15, 2024
Key facts
- NPI
- 1780912170
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OD60109766 (WA)
- Practice address
- 27101 Pioneer Hwy
Stanwood, WA 98292-6057 - Phone
- (360) 629-9535
- NPI assigned
- Nov 24, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 16
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- New England College of Optometry, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shoptikal LLC
Practice addresses (Care Compare)
1052 Springwater Ave
Wenatchee, WA 98801-1546
Phone (509) 663-8868
27101 Pioneer Hwy
Stanwood, WA 98292-6057
Phone (360) 629-9535
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 18 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140311000431 | WA | Practitioner - Optometry | 7618010455 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1723 | AZ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoptikal LLC | Optometrist | Current |
Accepting new patients |
| Shoptikal LLC | Optometrist | Current | Accepting new patients |
| Shoptikal LLC | Optometrist | Current |
Accepting new patients |
| Vision Plus Stanwood, PLLC | Optometrist | Current |
Accepting new patients |
| Stanwood Eye Clinic, Inc | Past |
Accepting new patients |
Locations
9520 N Newport Hwy
Spokane, WA 99218
Phone (509) 466-6871
27101 Pioneer Hwy
Stanwood, WA 98292
Phone (360) 629-9535
1340 N Wenatchee Ave
Wenatchee, WA 98801
Phone (509) 663-8868
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD60109766 | WA | Yes |
Addresses
Primary practice location
27101 Pioneer Hwy
Stanwood, WA 98292-6057
Mailing address
5801 Summitview Ave
Yakima, WA 98908-3006
Phone (509) 965-6405
Other providers in Stanwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.