Ryan Beck

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60755918 Issued in WA

Practice address

19400 108TH Ave SE
Kent, WA 98031-0108

Phone

(253) 852-2120

NPI assigned

Mar 31, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

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 and National Provider Directory roles.

• Bonney Lake Optical, Inc

  • Pediatric Optometrist
  • Bonney Lake, WA
  • NPI 1154478014
  Medicare reassignment NPD
• Federal Way Vision Center

  • Optometrist
  • Federal Way, WA
  • NPI 1336210483
  NPD (past)
• Kickapoo Management LLC

  • Eyewear Supplier
  • Perry, UT
  • NPI 1568849073
  NPD (past)

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1104289792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6544 RADIANCE BLVD E",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "98424",
            "telephone_number": "253-221-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19400 108TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980310108",
            "telephone_number": "253-852-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3045 19th Ave Apt 50",
            "address_purpose": "LOCATION",
            "city": "Forest Grove",
            "state": "OR",
            "postal_code": "971162663",
            "country_code": "US",
            "telephone_number": "253-221-0186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20901 SR 410 E",
            "address_purpose": "LOCATION",
            "city": "Bonney Lake",
            "state": "WA",
            "postal_code": "983916302",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECK",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60755918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Joyce D Lasquete Bautista, COTA/L
• Jeffrey W Baxter, MA LMFT LMHC
• John G Beack, D.M.D.
• Imelda Dizon Beal, RN
• Christine D Bechtold Morse, PT
• Karen Bedoya Alvarez
• Tricia M Beebe
• Behavior Group, LLC
• Fiker Behonegne
• Alemwosen Bekele

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.