Active NPI
William Balogh
- Optometrist
- Tacoma, WA
National Provider Identifier
1871667964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- O.D.00001030
- Legal business name
- WILLIAM BALOGH
- Practice address
- 1135 Broadway
Suite 101
Tacoma, WA 98402-3535 - Phone
- (253) 272-2136
- Fax
- (253) 272-6151
- NPI assigned
- Nov 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Maria L Burgos
- Title
- Office Manager
- Phone
- (253) 272-2136
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | O.D.00001030 | WA | Primary |
Addresses
Primary practice location
1135 Broadway
Suite 101
Tacoma, WA 98402-3535
Mailing address
1135 Broadway
Suite 101
Tacoma, WA 98402-3535
Phone (253) 272-2136
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BA3098 | Other | WA | REGENCE |
| WA0042 | Other | WA | NBN |
| 2051209 | Medicaid | WA | |
| 3908 | Other | WA | DAVIS VISION |
Other names 1
- BINYON OPTOMETRISTS
National Provider Directory
National Provider Directory- Tax ID family
- Binyon Optometrists
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Federal Way, WA
- NPI 1417022484
Locations
1135 Broadway
Ste 101
Tacoma, WA 98402
Phone (253) 272-2136
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1871667964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1135 BROADWAY",
"address_2": "SUITE 101",
"city": "TACOMA",
"state": "WA",
"postal_code": "984023535",
"telephone_number": "253-272-2136",
"fax_number": "253-272-6151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 BROADWAY",
"address_2": "SUITE 101",
"city": "TACOMA",
"state": "WA",
"postal_code": "984023535",
"telephone_number": "253-272-2136",
"fax_number": "253-272-6151"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLIAM BALOGH",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-20",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BURGOS",
"authorized_official_first_name": "MARIA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "253-272-2136",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "WA",
"license": "O.D.00001030",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "BA3098",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NBN",
"identifier": "WA0042",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2051209",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS VISION",
"identifier": "3908",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "BINYON OPTOMETRISTS",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.