Individual provider Active NPI

Wendy Kuo-Eveland, O.D.

  • Optometrist
  • Renton, WA
National Provider Identifier
1083915532
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60179790 Issued in WA
Practice address
4575 NE 4TH St Ste 2
Renton, WA 98059-5054
Phone
(425) 970-3230
Fax
(425) 970-3533
NPI assigned
Nov 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD601797790 WA
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 60179790 WA Primary

Addresses

Primary practice location

4575 NE 4TH St Ste 2
Renton, WA 98059-5054

Mailing address

4575 NE 4TH St Ste 2
Renton, WA 98059-5054
Phone (425) 970-3230

Other names 1

  • CHI-Wen Kuo Other name

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
I20110124000719 WA Practitioner - Optometry 4981883915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oceanclear Eyecare IncGroup PAC ID 0345480430, 2 clinicians

Practice addresses (Care Compare)

4605 NE 4TH St
Suite C
Renton, WA 98059-5055
Phone (425) 970-3230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60179790WAMDOptometrist
OD601797790WAMDOptometrist

Organizations & group practices 1

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": "1289692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1083915532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 NE 4TH ST STE 2",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980595054",
            "telephone_number": "425-970-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 NE 4TH ST STE 2",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980595054",
            "telephone_number": "425-970-3230",
            "fax_number": "425-970-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUO-EVELAND",
        "first_name": "WENDY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-14",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD601797790",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60179790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHI-WEN",
            "last_name": "KUO",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.