Individual provider Active NPI

Leigh Gongaware, OD

  • Optometrist
  • Ferndale, WA
National Provider Identifier
1154606200
Registry record updated Oct 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD 60481061 Issued in WA
Practice address
1815 Main St
Ferndale, WA 98248-9454
Phone
(360) 746-8890
Fax
(360) 393-4004
NPI assigned
Oct 19, 2011
Last updated
Oct 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD 60481061 WA Primary

Addresses

Primary practice location

1815 Main St
Ferndale, WA 98248-9454

Mailing address

1815 Main St
Ferndale, WA 98248-9454
Phone (360) 746-8890

Other identifiers 2

IdentifierTypeStateIssuer
2006335MedicaidWA
2087004MedicaidWA

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
I20171004003164 WA Practitioner - Optometry 7517232358 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sight Partners Physicians PCGroup PAC ID 6002728532, 59 clinicians

Practice addresses (Care Compare)

2075 Barkley Blvd
Suite 205
Bellingham, WA 98226-6614
Phone (360) 676-6233

Merit-based Incentive Payment System (MIPS)

Final score
89.74 of 100Reported as group
Quality
88.73
Promoting interoperability
100
Improvement activities
40
Cost
77.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD 60481061WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Division Eyecare Optometrist CurrentSince Sep 1, 2017 Accepting new patients
Vision Plus in Lynden Optometrist CurrentSince Sep 1, 2017 Accepting new patients
Sight Partners Physicians, P.C. Optometrist CurrentSince Sep 4, 2018 Accepting new patients
Sight Partners Physicians, P.C. Optometrist Current Accepting new patients
Vision Plus Inside Ferndale Haggen Optometrist CurrentSince Sep 1, 2017 Accepting new patients
Sight Partners Physicians PC CurrentSince Sep 4, 2018 Accepting new patients
Sight Partners Physicians, P.C. Optometrist Past Accepting new patients
Sight Partners Physicians, P.C. Optometrist Past Accepting new patients
Sight Partners Physicians, P.C. Optometrist Past Accepting new patients
Sight Partners Physicians, P.C. Optometrist Past Accepting new patients

Locations

16404 Smokey Point Blvd
Ste 303
Arlington, WA 98223
Phone (360) 658-6224

903 Medical Center Dr
Ste 100
Arlington, WA 98223
Phone (360) 435-8595

2075 Barkley Blvd
Ste 205
Bellingham, WA 98226
Phone (360) 676-6233

21906 76th Ave W
Edmonds, WA 98026
Phone (425) 577-4262

1815 Main St
Ferndale, WA 98248
Phone (360) 380-7210

1824 Front St
Ste B
Lynden, WA 98264
Phone (360) 933-1815

1306 Roosevelt Ave
Mount Vernon, WA 98273
Phone (360) 428-2020

31775 State Route 20
Ste B
Oak Harbor, WA 98277
Phone (360) 544-5843

31775 State Route 20
Ste B1
Oak Harbor, WA 98277
Phone (360) 544-5843

1412 SW 43rd St
Ste 310
Renton, WA 98057
Phone (425) 235-1200

332 NE Northgate Way
Seattle, WA 98125

795 N 5th Ave
Sequim, WA 98382
Phone (360) 658-6224

16010 E Indiana Ave
Spokane Valley, WA 99216
Phone (509) 928-8040

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1154606200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 MAIN ST",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982489454",
            "telephone_number": "360-746-8890",
            "fax_number": "360-393-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 MAIN ST",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982489454",
            "telephone_number": "360-746-8890",
            "fax_number": "360-393-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONGAWARE",
        "first_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 60481061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2006335",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2087004",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, WA

Sources for this page

Verify at the official NPI Registry.