Kevin D Osborne, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00003716 Issued in WA

Practice address

215 E Broadway Ave
Moses Lake, WA 98837-1717

Phone

(509) 764-7338

Fax

(509) 764-7878

NPI assigned

Mar 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.osborne@direct.revolutionehr.com

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.

• Revolution-Eyes LLC

  • Corneal and Contact Management Optometrist
  • Moses Lake, WA
  • NPI 1689904864
  Medicare reassignment NPD Authorized official
• Creviston and Pedersen LLC

  • Optometrist
  • Moses Lake, WA
  • NPI 1174641690
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1174656870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 S PIONEER WAY",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372381",
            "telephone_number": "509-764-7338",
            "fax_number": "509-764-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E BROADWAY AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371717",
            "telephone_number": "509-764-7338",
            "fax_number": "509-764-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "KEVIN",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2031243",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omni Staffing Services Inc
• James Uzoma Opara, MD
• Opthomastry, PLLC
• Brian Craig Osborne, MSW
• Jenni Mina Michelle Osborne
• Momodu Kamaru Oseni, FNP
• Oluwaseun Adetola Osonuga
• Preston J. Ottmar, PHARMD
• Brett L Pack, D.M.D.
• Pack'S Delivery LLC

• Optometrist in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.