Roderick Blair Beazer, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60530417 Issued in WA

Practice address

9623 32ND St SE Ste D121
Lake Stevens, WA 98258-5780

Phone

(425) 377-9747

Fax

(425) 377-8757

NPI assigned

Jul 7, 2012

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

Southern College of Optometry, 2012

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)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rbeazer@directaddress.net

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
• Cascade Family Eye Care, PLLC

  • Optometrist
  • Lake Stevens, WA
  • NPI 1053349613
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1341619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1790040673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9623 32ND ST SE",
            "address_2": "STE D121",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982585780",
            "telephone_number": "717-242-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9623 32ND ST SE STE D121",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982585780",
            "telephone_number": "425-377-9747",
            "fax_number": "425-377-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAZER",
        "first_name": "RODERICK",
        "middle_name": "BLAIR",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-07",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60530417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON DEPARTMENT OF HEALTH",
            "identifier": "OD60530417",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Barrett, BSN, RN
• Angela Marie Barrow, PHARMACY TECHNICIAN
• Tabitha Bas
• Tiffany Lynn Battenfield, LMP
• Courtney Marie Beason, PHARMD
• Kara Beck, M.A., CCC-SLP
• Behavioral Institute PLLC
• Suthida Belan, LMT
• Amanda Kay Bell, LMP
• Ashley Dawn Bemis, LMHC

• All providers in Lake Stevens, WA
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.