Burien Eyecare Center

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00004053 Issued in WA

Legal business name

BURIEN EYECARE CENTER

Practice address

625 SW 153Rd St
Burien, WA 98166-2216

Phone

(206) 242-8545

Fax

(206) 244-2020

NPI assigned

Mar 6, 2013

Organization subpart

No

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

Authorized official

Name

Jatinder Bansal, ODNPI 1578659322

Title

Doctor of Optometry

Phone

(425) 749-6766

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jatinder Bansal, O.D.

  • Optometrist
  • Dupont, WA
  • NPI 1578659322
  Medicare reassignment NPD Authorized official
• Angie Chan, OD

  • Optometrist
  • Burien, WA
  • NPI 1245259852
  NPD (past)

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362528000000",
    "number": "1972844652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SW 153RD ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662216",
            "telephone_number": "206-242-8545",
            "fax_number": "206-244-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 SW 153RD ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662216",
            "telephone_number": "206-242-8545",
            "fax_number": "206-244-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURIEN EYECARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A",
        "authorized_official_last_name": "BANSAL",
        "authorized_official_first_name": "JATINDER",
        "authorized_official_title_or_position": "DOCTOR OF OPTOMETRY",
        "authorized_official_telephone_number": "425-749-6766",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00004053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2012279",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Bunch, ARNP
• Kylee Bunch
• Lacey Erin Burchett, OTR
• Luis Burciaga
• Burien Digestive Health Center LLC
• Burien Family Acupuncture LLC
• Burien Family Eye Care, PLLC
• Burien Medical Clinic
• Burien Medical Eye Care, LLC
• Burien Medical Investors, LLC

• All providers in Burien, WA
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.