Individual provider Active NPI

Harshani Buddika Amaraweera

  • Optometrist
  • Bellevue, WA
National Provider Identifier
1043745839
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60762408 Issued in WA
Practice address
909 112TH Ave NE Apt 1005
Bellevue, WA 98004-8586
Phone
(206) 910-3838
NPI assigned
Apr 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD60762408 WA Primary

Addresses

Primary practice location

909 112TH Ave NE Apt 1005
Bellevue, WA 98004-8586

Mailing address

909 112TH Ave NE Apt 1005
Bellevue, WA 98004-8586
Phone (206) 910-3838

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
I20191101002227 WA Practitioner - Optometry 9537491006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Western University of Health Sciences College of Dental Med, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Ballard Optometry PLLCGroup PAC ID 9133537780, 2 clinicians

Practice addresses (Care Compare)

1719 NW Market St
Seattle, WA 98107-5225
Phone (206) 784-2090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ballard Optometry, PLLC Optometrist CurrentSince Mar 16, 2021 Accepting new patients
Bella Vision Corporation CurrentSince Sep 30, 2019 Accepting new patients

Locations

22616 Bothell Everett Hwy
Ste 2
Bothell, WA 98021
Phone (425) 486-8074

8862 161st Ave NE
Ste 105
Redmond, WA 98052
Phone (425) 881-6655

1719 NW Market St
Seattle, WA 98107
Phone (206) 784-2090

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": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1043745839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 112TH AVE NE APT 1005",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048586",
            "telephone_number": "206-910-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 112TH AVE NE APT 1005",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048586",
            "telephone_number": "206-910-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMARAWEERA",
        "first_name": "HARSHANI",
        "middle_name": "BUDDIKA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60762408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.