Individual provider Active NPI

Sorena Kaur, O.D.

  • Optometrist
  • Seattle, WA
National Provider Identifier
1124058060
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003556 Issued in WA
Practice address
12520 Lake City Way NE
Seattle, WA 98125-4425
Phone
(206) 906-9944
Fax
(206) 906-9309
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00003556 WA Primary
Optometrist 152W00000X 10956T CA

Addresses

Primary practice location

12520 Lake City Way NE
Seattle, WA 98125-4425

Mailing address

12520 Lake City Way NE
Seattle, WA 98125-4425
Phone (206) 906-9944

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
I20060831000354 WA Practitioner - Optometry 5496759656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12520 Lake City Way NE
Seattle, WA 98125-4425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10956TCAMDOptometrist
OD00003556WAMDOptometrist

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1124058060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12520 LAKE CITY WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254425",
            "telephone_number": "206-906-9944",
            "fax_number": "206-906-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 LAKE CITY WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254425",
            "telephone_number": "206-906-9944",
            "fax_number": "206-906-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "SORENA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003556",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10956T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.