Eye Institute, PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD00048106 Issued in WA

Legal business name

EYE INSTITUTE, PC

Practice address

1301 4TH Ave NW
Suite 200
Issaquah, WA 98027-9371

Phone

(425) 606-1359

Fax

(425) 642-8290

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Barry Vaughn Sandoval, MDNPI 1538225917

Title

Owner

Phone

(425) 606-1359

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Barry Vaughn Sandoval, MD

  • Ophthalmology Physician
  • Issaquah, WA
  • NPI 1538225917
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493078400000",
    "number": "1174724215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 4TH AVE NW",
            "address_2": "SUITE 200",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980279371",
            "telephone_number": "425-606-1359",
            "fax_number": "425-642-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 4TH AVE NW",
            "address_2": "SUITE 200",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980279371",
            "telephone_number": "425-606-1359",
            "fax_number": "425-642-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE INSTITUTE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2017-04-25",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "VAUGHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-606-1359",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00048106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "A20739210",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806458",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bentley Richard Everingham, RNFA
• Iveta Everingham, RNFA
• Alyssa Joy Ewell, CF- SLP
• Keesha Ewers, ARNP
• Eye Institute PC
• Evangelia Nicole Facchine, RD CD
• Ryan Face, DPT
• Jean Elizabeth Falls, LMHC WASHINGTON
• Kathryn K.O. Falso, PT
• Alexander Scott Fandrich, DPT, PT

• Ophthalmology Physician in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Ophthalmology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.