Individual provider Active NPI

Christine Ann Tasso, OD

  • Optometrist
  • Eagle River, AK
National Provider Identifier
1043280647
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
190 Issued in AK
Practice address
7015 Kulchay Cir
Eagle River, AK 99577-9100
Phone
(907) 575-2336
NPI assigned
Jan 25, 2006
Last updated
Aug 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 190 AK Primary

Addresses

Primary practice location

7015 Kulchay Cir
Eagle River, AK 99577-9100

Mailing address

7015 Kulchay Cir
Eagle River, AK 99577-9100
Phone (907) 575-2336

Other identifiers 1

IdentifierTypeStateIssuer
MD36553MedicaidAK

Other names 1

  • Christine Ann Burchardt Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051021000846 AK Practitioner - Optometry 6901822550 Reassigns benefits to 1 organization
I20200708001804 TX Practitioner - Optometry 6901822550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Wind River Family and Community Healthc CareGroup PAC ID 1850683780, 42 clinicians

Practice addresses (Care Compare)

14 Great Plains Rd
Arapahoe, WY 82510-9144
Phone 3078569281119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wind River Family & Community Healthc Care CurrentSince Jun 15, 2020 Accepting new patients
Cap Eye LLC Optometrist CurrentSince Jan 1, 2020 Accepting new patients
Classic Eyeware Past Accepting new patients
Michael J Bennett Optometrist Past Accepting new patients
Valley Eye Associates, PC Optometrist PastSince Jan 1, 2005 Accepting new patients
Alaska Center for the Blind and Visually Impaired PastSince Aug 1, 2009 Accepting new patients
William Y. to, O.D., Inc Optometrist PastSince Nov 15, 2021 Accepting new patients

Locations

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

3122 E Meridian Park Loop
Ste 2
Wasilla, AK 99654
Phone (907) 357-9595

14 Great Plains Rd
Arapahoe, WY 82510

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1043280647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 KULCHAY CIR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995779100",
            "telephone_number": "907-575-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 KULCHAY CIR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995779100",
            "telephone_number": "907-575-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASSO",
        "first_name": "CHRISTINE",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD36553",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "BURCHARDT",
            "middle_name": "ANN",
            "credential": "OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eagle River, AK

Sources for this page

Verify at the official NPI Registry.