Individual provider Active NPI

Kerry J Moscovitz, O.D.

  • Optometrist
  • Sammamish, WA
National Provider Identifier
1023127776
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3313TX Issued in WA
Practice address
22741 SE 29TH St
Sammamish, WA 98075-9532
Phone
(425) 392-2196
Fax
(425) 392-8934
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3313TX WA Primary

Addresses

Primary practice location

22741 SE 29TH St
Sammamish, WA 98075-9532

Mailing address

22741 SE 29TH St
Sammamish, WA 98075-9532
Phone (425) 392-2196

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
I20120207000403 WA Practitioner - Optometry 2961669783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eye and Contact Lens Center, P.S.Group PAC ID 0547158404, 2 clinicians

Practice addresses (Care Compare)

22741 SE 29TH St
Sammamish, WA 98075-9532
Phone (425) 392-2196

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3313TXWAMDOptometrist

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023127776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22741 SE 29TH ST",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980759532",
            "telephone_number": "425-392-2196",
            "fax_number": "425-392-8934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22741 SE 29TH ST",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980759532",
            "telephone_number": "425-392-2196",
            "fax_number": "425-392-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCOVITZ",
        "first_name": "KERRY",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3313TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sammamish, WA

Sources for this page

Verify at the official NPI Registry.