Benjamin Lee Waldo, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

60022188OD Issued in WA

Practice address

14201 NE 20TH Ave Ste A102
Vancouver, WA 98686-6411

Phone

(360) 574-6030

Fax

(360) 574-4116

NPI assigned

Apr 19, 2006

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

Southern College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salmon Creek Vision Centre, PLLCGroup PAC ID 2567520885, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Salmon Creek Vision Centre, PLLC

  • Optometrist
  • Vancouver, WA
  • NPI 1164670790
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1194780361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 NE 20TH AVE, STE A102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866411",
            "telephone_number": "360-574-6030",
            "fax_number": "360-574-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 NE 20TH AVE STE A102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866411",
            "telephone_number": "360-574-6030",
            "fax_number": "360-574-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDO",
        "first_name": "BENJAMIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2024-10-21",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60022188OD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores, Inc (Vision Center 30-2947)
• Wal-Mart Stores, Inc (Vision Center 30-2550)
• Wal-Mart Stores, Inc. (Wal-Mart Vision Center 30-5461)
• Angela M. Walborn, AAS, CDP
• Jazmin Walchli, CERTIFIED BEHAVIOR
• Sarah Waldron
• Sasha Waldstein
• Walgreen Co (Walgreens #09379)
• Walgreen Co (Walgreens #09380)
• Walgreen Co (Walgreens #10141)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.