Individual provider Active NPI

Nicholas Allen Donaghey, O.D.

  • Optometrist
  • Wenatchee, WA
National Provider Identifier
1063854479
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60440878 Issued in WA
Practice address
1190 5TH St
Wenatchee, WA 98801-1825
Phone
(509) 662-9671
Fax
(509) 662-9672
NPI assigned
Jul 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD60440878 WA Primary

Addresses

Primary practice location

1190 5TH St
Wenatchee, WA 98801-1825

Mailing address

47 Makenna LN
East Wenatchee, WA 98802-5198
Phone (816) 217-8822

Other practice location 1

131 S Apple Blossom Dr Unit 114
Chelan, WA 98816-8827
Phone (509) 661-6188

Other practice location 2

1133 US Highway 2 Ste G
Leavenworth, WA 98826-1439
Phone (509) 548-7379

Other identifiers 1

IdentifierTypeStateIssuer
1063854479MedicaidWA

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
I20140224001857 WA Practitioner - Optometry 0547490310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Source of Wenatchee, PSGroup PAC ID 0749294536, 6 clinicians

Practice addresses (Care Compare)

1190 5TH St
Wenatchee, WA 98801-1825
Phone (509) 662-9671

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD60440878WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Source of Wenatchee, PS Optometrist CurrentSince Mar 27, 2015 Accepting new patients
Vision Source of Wenatchee, PS Optometrist CurrentSince Mar 27, 2015 Accepting new patients
Vision Source of Wenatchee, PS Optometrist Current Accepting new patients
Ellensburg Vision Clinic, PS, Inc Optometrist Past Accepting new patients

Locations

131 S Apple Blossom Dr
Unit 114
Chelan, WA 98816
Phone (509) 661-6188

1133 US Highway 2
Ste G
Leavenworth, WA 98826
Phone (509) 548-5411

1190 5th St
Wenatchee, WA 98801
Phone (509) 622-9671

Interoperability endpoints

  • Direct secure messaging: ndonaghey@visionsourcewen.eyefinity-direct.com
  • Direct secure messaging: emmc-painmanagement@direct.emhs.org

Organizations & group practices 4

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": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1063854479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 MAKENNA LN",
            "city": "EAST WENATCHEE",
            "state": "WA",
            "postal_code": "988025198",
            "telephone_number": "816-217-8822",
            "fax_number": "509-662-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 5TH ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011825",
            "telephone_number": "509-662-9671",
            "fax_number": "509-662-9672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 S Apple Blossom Dr Unit 114",
            "address_purpose": "LOCATION",
            "city": "Chelan",
            "state": "WA",
            "postal_code": "988168827",
            "country_code": "US",
            "telephone_number": "509-661-6188",
            "fax_number": "509-237-6426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1133 US Highway 2 Ste G",
            "address_purpose": "LOCATION",
            "city": "Leavenworth",
            "state": "WA",
            "postal_code": "988261439",
            "country_code": "US",
            "telephone_number": "509-548-7379",
            "fax_number": "509-548-4524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONAGHEY",
        "first_name": "NICHOLAS",
        "middle_name": "ALLEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-25",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60440878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063854479",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.