Individual provider Active NPI

Lydia Pan, O.D.

  • Optometrist
  • Bellingham, WA
National Provider Identifier
1114054426
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3433 Issued in WA
Practice address
4299 Meridian St
Bellingham, WA 98226-6475
Phone
(360) 647-6771
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3433 WA Primary

Addresses

Primary practice location

4299 Meridian St
Bellingham, WA 98226-6475

Mailing address

625 N Garden St Apt 303
Bellingham, WA 98225-5435

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
I20070926000161 WA Practitioner - Optometry 0749374403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clearview Eyecare PLLCGroup PAC ID 1557516358, 3 clinicians
Binyon Vision Bellingham PLLCGroup PAC ID 3779980578, 2 clinicians

Practice addresses (Care Compare)

410 W Bakerview Rd
Suite 107
Bellingham, WA 98226-8184
Phone (360) 392-8306

411 E Magnolia St
Bellingham, WA 98225-4510
Phone (360) 647-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3433WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clearview Eyecare, PLLC Optometrist CurrentSince Jun 23, 2020 Accepting new patients
Binyon Optometrists, Inc .PS Optometrist CurrentSince May 1, 2024 Accepting new patients
Binyon Vision Bellingham PLLC Optometrist CurrentSince May 1, 2024 Accepting new patients
Clearview Eyecare, P.C. Past Accepting new patients

Locations

411 E Magnolia St
Bellingham, WA 98225
Phone (360) 647-2020

410 W Bakerview Rd
Ste 107
Bellingham, WA 98226
Phone (360) 392-8306

Organizations & group practices 4

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114054426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N GARDEN ST APT 303",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4299 MERIDIAN ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266475",
            "telephone_number": "360-647-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "LYDIA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.