Grady G Hollenbeck, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3816 Issued in WA

Practice address

17224 SE 272ND St
Ste B
Covington, WA 98042-4953

Phone

(425) 260-6428

NPI assigned

Dec 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Eye Doctors Northwest PLLC

  dba Advanced Eye Care of Covington

  • Optometrist
  • Covington, WA
  • NPI 1124420526
  Medicare reassignment NPD Authorized official
• Dr Tiffany J Hollenbeck PLLC

  dba Redmond Ridge Eye Care

  • Optometrist
  • Redmond, WA
  • NPI 1760539969
  NPD (past)
• Vanessa Michel PLLC

  dba Redmond Ridge Eye Care

  • Optometrist
  • Redmond, WA
  • NPI 1437480456
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1134284151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17224 SE 272ND ST",
            "address_2": "STE B",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424953",
            "telephone_number": "425-260-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17224 SE 272ND ST",
            "address_2": "STE B",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424953",
            "telephone_number": "425-260-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLENBECK",
        "first_name": "GRADY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3816",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "710",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evafaye Dee Hiatt, NP
• Brittany Ho
• Hannah May Ho
• John Andrew Hodges, D.D.S. P.S.
• Sally Hogsted
• Galina Hoppe, RN
• Vanessa Ellen Howell, B.A.
• Matthew Huang, DDS
• Hunter Womens Health Care PLLC
• Catherine Ann Hunter, D.O.

• Optometrist in Covington, WA
• Providers in Covington, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.