Matthew Phillip Polster, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

61071257 Issued in WA

Practice address

301 N Broadway St Ste 4
Aberdeen, WA 98520-3933

Phone

(360) 533-1880

NPI assigned

Sep 21, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grays Harbor Vision Clinic, Inc.Group PAC ID 4284523424, 2 clinicians

Olympic Family Vision PLLCGroup PAC ID 9830680297, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Olympic Family Vision, PLLC

  • Optometrist
  • Aberdeen, WA
  • NPI 1619766243
  Medicare reassignment Care Compare group NPD Authorized official
• Grays Harbor Vision Clinic, Inc.

  • Clinic/Center
  • Aberdeen, WA
  • NPI 1265522932

  Optometrist

  Medicare reassignment Care Compare group NPD
• Bridgeport Family Vision Clinic, PLLC

  • Optometrist
  • Lakewood, WA
  • NPI 1235517541
  Medicare reassignment NPD
• David Thomas Williams

  • Optometrist
  • Lakewood, WA
  • NPI 1508043019
  NPD (past)

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1154604692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N BROADWAY ST STE 4",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985203933",
            "telephone_number": "360-533-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N BROADWAY ST STE 4",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985203933",
            "telephone_number": "360-533-1880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9801 204th Ave E",
            "address_purpose": "LOCATION",
            "city": "Bonney Lake",
            "state": "WA",
            "postal_code": "983916559",
            "country_code": "US",
            "telephone_number": "253-750-8135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLSTER",
        "first_name": "MATTHEW",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-21",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "61071257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherwin Phillips
• Erin Pickar, CDPT
• Nicole Leann Pickernell, CDPT
• Jon Edward Pitts, DDS
• Roberta Player
• Kacie Rose Powell
• Candi Dyan Prescott, CP60757485
• Edward Ray-Axe Prescott
• James Marcus Pritchett, D.D.S. P.S.
• Providence Health & Services Washington

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.