Individual provider Active NPI

Gary Lee Savage, O.D.

  • Optometrist
  • Everett, WA
National Provider Identifier
1922040823
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2085 Issued in WA
Practice address
9623 32ND St SE
D-121
Everett, WA 98205-2424
Phone
(425) 377-9747
Fax
(425) 377-8757
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2085 WA Primary

Addresses

Primary practice location

9623 32ND St SE
D-121
Everett, WA 98205-2424

Mailing address

9623 32ND St SE
Suite D-121
Everett, WA 98205-2424
Phone (425) 377-9747

Other identifiers 1

IdentifierTypeStateIssuer
2031821MedicaidWA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2085WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Washington Professional PC Optometrist PastSince Jan 23, 2008 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1922040823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9623 32ND ST SE",
            "address_2": "SUITE D-121",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982052424",
            "telephone_number": "425-377-9747",
            "fax_number": "425-377-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9623 32ND ST SE",
            "address_2": "D-121",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982052424",
            "telephone_number": "425-377-9747",
            "fax_number": "425-377-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAVAGE",
        "first_name": "GARY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "2085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2031821",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.