Timothy Glenn Mock, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60677430 Issued in WA

Practice address

1101 Madison St Ste 600
Seattle, WA 98104-1340

Phone

(206) 215-2020

Fax

(206) 215-2022

NPI assigned

Sep 24, 2016

Last updated

Jan 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Associates Northwest PLLCGroup PAC ID 2961397385, 10 clinicians

Evergreen Eye Center PLLCGroup PAC ID 3173410057, 33 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.62 of 100Reported as group

Quality

85.07

Improvement activities

40

Cost

76.1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evergreen Eye Center, PLLC

  dba Evergreen Eye Center

  • Ophthalmology Physician
  • Federal Way, WA
  • NPI 1700959293

  Optometrist

  Medicare reassignment Care Compare group NPD
• Eye Associates Northwest, PLLC

  dba Eye Associates Northwest

  • Ophthalmology Physician
  • Seattle, WA
  • NPI 1811952815
  Medicare reassignment Care Compare group NPD
• Evergreen Eye Center, PLLC

  dba Eye Associates Northwest Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
  • NPI 1184689408
  NPD
• Evergreen Eye Center, PLLC

  dba Eye Associates Northwest, PLLC

  • Ophthalmology Physician
  • Seattle, WA
  • NPI 1275387995
  NPD (past)
• Evergreen Eye Center, PLLC

  dba Evergreen Eye Center

  • Ophthalmology Physician
  • Burien, WA
  • NPI 1538238043

  Optometrist

  NPD (past)
• Evergreen Eye Center, PLLC

  dba Evergreen Eye Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Federal Way, WA
  • NPI 1821167479
  NPD (past)

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

{
    "created_epoch": "1474675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1063961654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 600",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041340",
            "telephone_number": "206-215-2020",
            "fax_number": "206-215-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST STE 600",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041340",
            "telephone_number": "206-215-2020",
            "fax_number": "206-215-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "TIMOTHY",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-24",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "100382",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60677430",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60677430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2237369",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kara Nadine Mochan, APRN-BC
• Shione Mochizuki
• Yoshihiro Mochizuki, MD
• Anne Marie Mariko Mock, PHARM.D.
• Charles N Mock, MD
• Blair Kristen Mockler, MD
• Amir Modarressi, MD
• Modern Dermatology, PLLC
• Purvi Mody
• Michael David Modzelewski, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.