Mark D Balter, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1411TX Issued in WA

Practice address

2201 NW Market St
Seattle, WA 98107-4025

Phone

(206) 789-7417

Fax

(206) 789-7651

NPI assigned

Oct 12, 2006

Last updated

May 7, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mark David Balter OD, PS

  dba Northwest Vision Clinic

  • Optometrist
  • Seattle, WA
  • NPI 1407935513
  Authorized official Same address or phone

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1841389152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 NW MARKET ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074025",
            "telephone_number": "206-789-7417",
            "fax_number": "206-789-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 NW MARKET ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074025",
            "telephone_number": "206-789-7417",
            "fax_number": "206-789-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTER",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1411TX",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "1411TX",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Fern Balsam, PH.D.
• Cameron Balt
• Grace G Baltazar
• Kathe Ceil Balter, MSW
• Ken W Balter, PA C
• Elsa Balton, MS, CGC
• Timothy J. Baltz, M.D.
• William M Baluch, P.A.
• Sarah Balzar, PHARMD
• Michelle Balzer

• Optometrist in Seattle, WA
• Providers in Seattle, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.