Individual provider Active NPI

Clayton Krager

  • Optometrist
  • Spokane, WA
National Provider Identifier
1124703384
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
61434101 Issued in WA
Practice address
4750 N Division St # 1010
Spokane, WA 99207-1411
Phone
(509) 596-9879
NPI assigned
Jun 15, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 61434101 WA Primary

Addresses

Primary practice location

4750 N Division St # 1010
Spokane, WA 99207-1411

Mailing address

4750 N Division St # 1010
Spokane, WA 99207-1411

Other practice location 1

14700 E Indiana Ave Spc 1008
Spokane Valley, WA 99216-1841
Phone (509) 596-9880

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
I20240228001570 WA Practitioner - Optometry 5698110740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Eye Care Center PCGroup PAC ID 4385946839, 3 clinicians

Practice addresses (Care Compare)

126 N Washington St
Spokane, WA 99201-0223
Phone (509) 747-6581

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61434101WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kyle Sexton, O.D., LLC Optometrist CurrentSince Jan 16, 2024 Accepting new patients
Washington Eye Care Center PC Optometrist CurrentSince Sep 1, 2024 Accepting new patients
Eye Care Team Inc Optometrist PastSince Sep 1, 2024 Accepting new patients

Locations

306 N Park St
Chewelah, WA 99109
Phone (509) 935-2020

3500 S Meridian
Ste 926
Puyallup, WA 98373
Phone (253) 864-9350

126 N Washington St
Ste A
Spokane, WA 99201

4750 N Division St
Ste 1010
Spokane, WA 99207
Phone (509) 596-9879

126 N Washington St
Spokane, WA 99201
Phone (509) 747-6581

14700 E Indiana Ave
Spc 1008
Spokane Valley, WA 99216
Phone (509) 596-9880

Organizations & group practices 3

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": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1124703384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 N DIVISION ST # 1010",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 N DIVISION ST # 1010",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071411",
            "telephone_number": "509-596-9879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14700 E Indiana Ave Spc 1008",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992161841",
            "country_code": "US",
            "telephone_number": "509-596-9880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAGER",
        "first_name": "CLAYTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "61434101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.