Individual provider Active NPI

David L Kading, OD

  • Optometrist
  • Kirkland, WA
National Provider Identifier
1013029719
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00004018 Issued in WA
Practice address
11830 NE 128TH St
Ste 1
Kirkland, WA 98034-7202
Phone
(425) 821-8900
Fax
(425) 814-9782
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00004018 WA Primary

Addresses

Primary practice location

11830 NE 128TH St
Ste 1
Kirkland, WA 98034-7202

Mailing address

355 Merritt PL NE
North Bend, WA 98045-8984
Phone (503) 349-4750

Other identifiers 1

IdentifierTypeStateIssuer
2031359MedicaidWA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050929000528 WA Practitioner - Optometry 5496714925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Eyecare Group IncGroup PAC ID 8325122823, 5 clinicians

Practice addresses (Care Compare)

11830 NE 128TH St
Suite 1
Kirkland, WA 98034-7202
Phone (425) 821-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Eyecare Group Inc Optometrist CurrentSince Dec 17, 2007 Accepting new patients
Richard S. Kenny, O.D., P.S. Optometrist PastSince Nov 18, 2014 Accepting new patients
Northwest Vision Consultants PastSince Dec 19, 2017 Accepting new patients

Locations

225 106th Ave NE
Bellevue, WA 98004
Phone (425) 454-2028

11830 NE 128th St
Ste 1
Kirkland, WA 98034
Phone (425) 814-8900

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1013029719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 MERRITT PL NE",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980458984",
            "telephone_number": "503-349-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11830 NE 128TH ST",
            "address_2": "STE 1",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347202",
            "telephone_number": "425-821-8900",
            "fax_number": "425-814-9782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADING",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00004018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2031359",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.