Bryan J. Heitmeyer, O.D.
Individual provider Active NPI Optometrist · Kent, WA
NPI 1124154315 · NPPES record last updated Jun 27, 2011
Key facts
- NPI
- 1124154315
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OD00003905 (WA)
- Practice address
- 8009 S 180TH St Ste 104
Kent, WA 98032-1042 - Phone
- (425) 251-9200
- Fax
- (425) 251-9201
- NPI assigned
- Feb 24, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Ohio State University - College of Optometry, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aeg Washington Professional PC
Practice addresses (Care Compare)
8009 S 180TH St
Suite 104
Kent, WA 98032-1042
Phone (425) 251-9200
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 11 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040806000822 | WA | Practitioner - Optometry | 1355313750 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OD00003905 | WA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clearvue Vision Center, PLLC | Optometrist | Current |
Accepting new patients |
| Aeg Washington Professional PC | Optometrist | Current |
Accepting new patients |
| Darran Kim O.D. PLLC | Optometrist | Past |
Accepting new patients |
Locations
12310 NE 8th St
Ste 101
Bellevue, WA 98005
Phone (425) 455-0001
8009 S 180th St
Ste 104
Kent, WA 98032
Phone (425) 251-9200
1098 Alder Ave
Marysville, WA 98270
Phone (360) 659-6255
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD00003905 | WA | Yes |
Addresses
Primary practice location
8009 S 180TH St Ste 104
Kent, WA 98032-1042
Mailing address
8009 S 180TH St Ste 104
Kent, WA 98032-1042
Phone (425) 251-9200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2188HE | Other | WA | REGENCE |
| 2730027 | Other | WA | UNITED HEALTHCARE |
| 7364884 | Other | WA | AETNA |
| 226820 | Other | WA | LABOR & INDUSTRY |
Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.