NPIMap

Organization Active NPI

Eye Clinic of Bellevue LTD PS

  • Ophthalmology Physician
  • Bellevue, WA
National Provider Identifier
1144358417
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD00018638 Issued in WA
Legal business name
EYE CLINIC OF BELLEVUE LTD PS
Practice address
1300 116TH Ave NE
Bellevue, WA 98004-3820
Phone
(425) 454-7912
Fax
(425) 454-7034
NPI assigned
Mar 1, 2007
Last updated
Aug 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Authorized official

Name
Kent Bassett, MDNPI 1821002403
Title
President
Phone
(425) 454-7912

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD00018638 WA Primary

Addresses

Primary practice location

1300 116TH Ave NE
Bellevue, WA 98004-3820

Mailing address

1300 116TH Ave NE
Bellevue, WA 98004-3820
Phone (425) 454-7912

Other identifiers 1

IdentifierTypeStateIssuer
7716509MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000689 WA Part B Supplier - Clinic/Group Practice 5991694192 Receives reassigned benefits from 6 practitioners
Practice locations: Issaquah, WA; Bellevue, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Eye Clinic of Bellevue2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7315 212th St SW
Ste 209
Edmonds, WA 98026

6520 226th Pl SE
Ste 204
Issaquah, WA 98027
Phone (425) 391-8602

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314230400000",
    "number": "1144358417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043820",
            "telephone_number": "425-454-7912",
            "fax_number": "425-454-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043820",
            "telephone_number": "425-454-7912",
            "fax_number": "425-454-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CLINIC OF BELLEVUE LTD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2011-08-25",
        "status": "A",
        "authorized_official_last_name": "BASSETT",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-454-7912",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00018638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7716509",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.