McKenzie Suzanne Fogarty, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60864286 Issued in WA

Practice address

34719 6TH Ave S
Federal Way, WA 98003-8714

Phone

(206) 260-2503

Fax

(855) 929-1515

NPI assigned

Sep 13, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evergreen Eye Center PLLCGroup PAC ID 3173410057, 33 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.68 of 100Reported as group

Quality

100

Improvement activities

40

Cost

78.95

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mfogarty@cepwa-eec.emadirect.md

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.

• Evergreen Eye Center, PLLC

  • Ophthalmology Physician
  • Federal Way, WA
  • NPI 1700959293

  Optometrist

  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Evergreen Eye Center, PLLC

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
  • NPI 1184689408
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1669619870
  NPD
• Evergreen Eye Center, PLLC

  • Ophthalmology Physician
  • Seattle, WA
  • NPI 1275387995

  Multi-Specialty

  NPD (past)
• Evergreen Eye Center, PLLC

  • Ophthalmology Physician
  • Burien, WA
  • NPI 1538238043

  Optometrist

  NPD (past)
• Evergreen Eye Center, PLLC

  • Ambulatory Surgical Clinic/Center
  • Federal Way, WA
  • NPI 1821167479
  NPD (past)
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1184915167
  NPD (past)

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1063995181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34719 6TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038714",
            "telephone_number": "206-260-2503",
            "fax_number": "855-929-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34719 6TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038714",
            "telephone_number": "206-260-2503",
            "fax_number": "855-929-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9720 4th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981152143",
            "country_code": "US",
            "telephone_number": "206-302-1200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1230 W Sprague Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992014181",
            "country_code": "US",
            "telephone_number": "775-772-0857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4815 N Assembly St",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992056185",
            "country_code": "US",
            "telephone_number": "775-772-0857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "MCKENZIE",
        "middle_name": "SUZANNE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60864286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2139817",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Flanagan, LMHC
• Shayla Fletcher
• Alexis Michelle Florence
• Flowart Therapy, PLLC
• Kellie Fochtman, EAMP
• Andorra L Foley, DNP, ACCNS-AG, CEN
• Sue Ann Folker, MS, OTR/L
• Ariel Folsom
• Sydney Fone, LICSW
• Keith Gilman Fongemie, PHARMD

• Optometrist in Federal Way, WA
• Providers in Federal Way, 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.