Charissa Young, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60563082 Issued in WA

Practice address

11830 NE 128TH St Ste 1
Kirkland, WA 98034-7202

Phone

(425) 821-8900

NPI assigned

Oct 10, 2012

Last updated

Jul 1, 2015By the provider in NPPES

Sex

Female

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

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eric Bergstrom OD, PLLCGroup PAC ID 0941190417, 11 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eric Bergstrom OD, PLLC

  dba Eye Clinics of Seattle - Roosevelt

  • Optometrist
  • Seattle, WA
  • NPI 1124289897
  Medicare reassignment Care Compare group NPD
• Puget Sound Eye Care

  • Optometrist
  • Seattle, WA
  • NPI 1659426211
  Medicare reassignment NPD
• Specialty Eyecare Group Inc

  dba Totem Lake Vision Center

  • Optometrist
  • Kirkland, WA
  • NPI 1235317637
  Medicare reassignment NPD
• Northwest Vision Consultants

  • Vision Therapy Optometrist
  • Kirkland, WA
  • NPI 1437691425
  NPD (past)

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1184976417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11830 NE 128TH ST STE 1",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11830 NE 128TH ST STE 1",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347202",
            "telephone_number": "425-821-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CHARISSA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60563082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolo Massage Clinic
• Yong J. Park DDS, Inc. (Lake Washington Dental)
• Kaci Emiko Yoshimura
• Esther Yost
• Andrew Young, DDS
• Felix J Young, DPT
• Julie A Young, ARNP
• Raymond Young, RPH
• William Gregory Young Jr., M.D.
• Joel Bruce Younger, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.