Individual provider Active NPI

James E Kintner, O.D.

  • Optometrist
  • Kennewick, WA
National Provider Identifier
1043366610
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00002049 Issued in WA
Practice address
3700 W Clearwater Ave
Kennewick, WA 99336
Phone
(509) 735-1312
Fax
(506) 736-6403
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00002049 WA Primary

Addresses

Primary practice location

3700 W Clearwater Ave
Kennewick, WA 99336

Mailing address

3700 W Clearwater Ave
Kennewick, WA 99336-2636
Phone (509) 735-1312

Other identifiers 1

IdentifierTypeStateIssuer
2022150MedicaidWA

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
I20040721000121 WA Practitioner - Optometry 8729068838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Visionary Eyecare PLLCGroup PAC ID 8224441357, 4 clinicians

Practice addresses (Care Compare)

3700 W Clearwater Ave
Kennewick, WA 99336-2636
Phone (509) 735-1312

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD00002049WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Visionary Eyecare PLLC Optometrist Current Accepting new patients
Washington Visionary Eyecare PLLC Optometrist CurrentSince Sep 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington Past Accepting new patients

Locations

5961 S Los Altos Pkwy
Ste 101
Sparks, NV 89436
Phone (775) 359-2020

3700 W Clearwater Ave
Kennewick, WA 99336
Phone (509) 735-1312

11700 Mukilteo Speedway
Ste 501
Mukilteo, WA 98275
Phone (425) 315-8300

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1043366610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362636",
            "telephone_number": "509-735-1312",
            "fax_number": "506-736-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-735-1312",
            "fax_number": "506-736-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINTNER",
        "first_name": "JAMES",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00002049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2022150",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.