Individual provider Active NPI

Stephen D Nevett, OD

  • Optometrist
  • Seattle, WA
National Provider Identifier
1023202140
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60060955 Issued in WA
Practice address
401 NE Northgate Way SPC 1101
Seattle, WA 98125-8538
Phone
(206) 364-2273
Fax
(206) 364-2576
NPI assigned
Aug 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2753ATI OR
Optometrist 152W00000X 6000TG TX
Optometrist 152W00000X 60060955 WA Primary

Addresses

Primary practice location

401 NE Northgate Way SPC 1101
Seattle, WA 98125-8538

Mailing address

401 NE Northgate Way SPC 1101
Seattle, WA 98125-8538
Phone (206) 364-2273

Other identifiers 1

IdentifierTypeStateIssuer
2075593MedicaidWA

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
I20101230000351 WA Practitioner - Optometry 9234212143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Stephen Nevett and Associates PCGroup PAC ID 0648468975, 10 clinicians

Practice addresses (Care Compare)

401 NE Northgate Way
SPC 1101
Seattle, WA 98125-8538
Phone (206) 364-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2753ATIORMDOptometrist
6000TGTXMDOptometrist
60060955WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Stephen Nevett and Associates, P.C. Optometrist CurrentSince Oct 22, 2010 Accepting new patients
Luxottica of America Inc PastSince Mar 6, 2022 Accepting new patients

Locations

11901 NE Village Plz
Ste 169
Kirkland, WA 98034
Phone (425) 602-6152

2701 184th St SW
Ste 109
Lynnwood, WA 98037
Phone (425) 712-8443

401 NE Northgate Way
Spc 1101
Seattle, WA 98125
Phone (206) 364-1668

401 NE Northgate Way
Ste 530
Seattle, WA 98125
Phone (206) 364-1668

Organizations & group practices 2

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": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1023202140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NE NORTHGATE WAY SPC 1101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981258538",
            "telephone_number": "206-364-2273",
            "fax_number": "206-364-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NE NORTHGATE WAY SPC 1101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981258538",
            "telephone_number": "206-364-2273",
            "fax_number": "206-364-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVETT",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-31",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2753ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6000TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60060955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2075593",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.