Jasonpreet Dhaliwal, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD61189494 Issued in WA

Practice address

1801 10TH Ave NW
Issaquah, WA 98027-5384

Phone

(425) 369-6726

NPI assigned

Jul 16, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Blue Wave Eye Doctors Professional Limited Liability Company

  • Optometrist
  • Everett, WA
  • NPI 1053060475
  Medicare reassignment NPD
• Bonney Lake Optical, Inc

  • Pediatric Optometrist
  • Bonney Lake, WA
  • NPI 1154478014
  Medicare reassignment NPD
• Blue Wave Eye Doctors Professional Limited Liability Company

  • Eyewear Supplier
  • Olympia, WA
  • NPI 1902608755
  NPD

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1972176006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 SMITHERS AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980554208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 10TH AVE NW",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275384",
            "telephone_number": "425-369-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "JASONPREET",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61189494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lechic Devereaux Franco
• Chaitra Elise Devereaux, PSYD
• Jennifer Michelle Devine, MD
• Avneet Kaur Dhaliwal, DMD
• Hardeep Dhaliwal, MD, DMD
• Mannat Kaur Dhillon
• Christina Lynn Diamonti, PSYD
• Karem Diaz
• Veronica Itzel Diaz, LMHCA
• Seema Diddee, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.