Vanessa Victoria Gregorius, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD61072477 Issued in WA

Practice address

12728 19TH Ave SE # 102
Everett, WA 98208-6526

Phone

(425) 353-5544

NPI assigned

May 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Vanessa Victoria Cisneros Former name

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Plus of Silver Lake PLLCGroup PAC ID 8426455924, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Vision Plus of Silver Lake PLLC

  • Optometrist
  • Everett, WA
  • NPI 1891461117
  Medicare reassignment Care Compare group NPD
• Joseph S Wald Enterprises Inc

  • Optometrist
  • Burlington, WA
  • NPI 1518132729
  NPD

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1023630555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12728 19TH AVE SE # 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086526",
            "telephone_number": "425-353-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12728 19TH AVE SE # 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086526",
            "telephone_number": "425-353-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORIUS",
        "first_name": "VANESSA",
        "middle_name": "VICTORIA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2021-09-08",
        "certification_date": "2021-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61072477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "CISNEROS",
            "middle_name": "VICTORIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leslie A Greene, M.D.
• Kali Lila-Rose Greenhalgh
• Stephen Kelly Greenhouse, PSY.D.
• Tammy Greer
• Phillip Kenneth Gregoire, MD
• Gregory a Hanson DDS PS
• Susan Gregory
• Thomas W Greisamer, M.D.
• McKenzie Marie Grenz
• Justine Kaur Grewal, DC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.