NPIMap

Organization Active NPI

North Cascade Eye Associates PS

  • Ophthalmology Physician
  • Mount Vernon, WA
National Provider Identifier
1093750481
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NORTH CASCADE EYE ASSOCIATES PS
Practice address
2100 Little Mountain LN
Mount Vernon, WA 98274-8752
Phone
(360) 416-6735
Fax
(360) 424-6954
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Authorized official

Name
Dr. Nannette E Crowell, M.D.
Title
President
Phone
(360) 416-6735

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2100 Little Mountain LN
Mount Vernon, WA 98274-8752

Mailing address

2100 Little Mountain LN
Mount Vernon, WA 98274-8752
Phone (360) 416-6735

Other identifiers 1

IdentifierTypeStateIssuer
7301229MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040213000128 WA Part B Supplier - Clinic/Group Practice 5991699498 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
Practice locations: Coupeville, WA; Mount Vernon, WA; Sedro Woolley, WA; Stanwood, WA
O20100930031538 WA DME Supplier - Physician - Optometrist 5991699498 Practice locations: Mount Vernon, WA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Cascadia Eye Little Mountain2100 Little Mountain LN, Mount Vernon, WA 98274-8752(360) 424-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Apr 29, 2008

National Provider Directory

National Provider Directory
Tax ID family
North Cascade Eye Associates PS5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

26910 92nd Ave NW
#6
Stanwood, WA 98292
Phone (360) 629-4180

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1093750481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LITTLE MOUNTAIN LN",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982748752",
            "telephone_number": "360-416-6735",
            "fax_number": "360-424-6954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LITTLE MOUNTAIN LN",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982748752",
            "telephone_number": "360-416-6735",
            "fax_number": "360-424-6954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CASCADE EYE ASSOCIATES PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "CROWELL",
        "authorized_official_first_name": "NANNETTE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-416-6735",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301229",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.