Individual provider Active NPI

Stephen L. Christensen, O.D.

  • Optometrist
  • Kennewick, WA
National Provider Identifier
1124109608
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
037 Issued in AZ
Practice address
1321 N Columbia Center Blvd
Ste 419
Kennewick, WA 99336-2455
Phone
(480) 861-7331
Fax
(480) 755-3534
NPI assigned
Oct 18, 2006
Last updated
May 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 037 AZ Primary

Addresses

Primary practice location

1321 N Columbia Center Blvd
Ste 419
Kennewick, WA 99336-2455

Mailing address

3911 S Lincoln St
Kennewick, WA 99338-9230
Phone (480) 861-7331

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
I20150902000278 WA Practitioner - Optometry 5890697965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1321 N Columbia Ctr Blvd
Suite 419
Kennewick, WA 99336-7184
Phone (509) 820-2500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
037AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
S L Christensen O D & Assoc P C Optometrist CurrentSince May 2, 2015 Accepting new patients
Optometric Special Testing Centers, Inc. Optometrist PastSince Apr 30, 2003 Accepting new patients

Locations

1929 E Ray Rd
Ste 2
Chandler, AZ 85225
Phone (480) 498-8825

12450 N 32nd St
Phoenix, AZ 85032
Phone (602) 494-0054

12450 N 32nd St
Ste 2
Phoenix, AZ 85032
Phone (602) 953-2020

1321 N Columbia Center Blvd
Ste 419
Kennewick, WA 99336
Phone (509) 735-3022

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1124109608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 S LINCOLN ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993389230",
            "telephone_number": "480-861-7331",
            "fax_number": "480-755-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N COLUMBIA CENTER BLVD",
            "address_2": "STE 419",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362455",
            "telephone_number": "480-861-7331",
            "fax_number": "480-755-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "STEPHEN",
        "middle_name": "L.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.