NPIMap

Organization Active NPI

Eyecare Partners, PLLC

  • Corneal and Contact Management Optometrist
  • Sammamish, WA
National Provider Identifier
1235628579
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
OD00003256 Issued in WA
Legal business name
EYECARE PARTNERS, PLLC
Practice address
22620 SE 4TH St Ste 110
Sammamish, WA 98074-7375
Phone
(425) 242-6868
Fax
(425) 831-0027
NPI assigned
May 2, 2018
Organization subpart
Yes
Parent organization
EYECARE PARTNERS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Authorized official

Name
Rebecca Dale, M.D
Title
Owner/Doctor
Phone
(425) 831-2020

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X OD00003256 WA Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X

Addresses

Primary practice location

22620 SE 4TH St Ste 110
Sammamish, WA 98074-7375

Mailing address

22620 SE 4TH St Ste 110
Sammamish, WA 98074-7375
Phone (425) 242-6868

Other identifiers 1

IdentifierTypeStateIssuer
2103053MedicaidWA

Other names 1

  • Arbor Eyecare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140516001424 WA Part B Supplier - Clinic/Group Practice 7911120084 Receives reassigned benefits from 10 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Bend, WA; Sammamish, WA; Snoqualmie, WA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Eyecare Partners PLLC2 organizations share this tax ID, including this one
Part of
Eyecare Partners PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

126 E 2nd St
North Bend, WA 98045
Phone (425) 831-2020

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1235628579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22620 SE 4TH ST STE 110",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980747375",
            "telephone_number": "425-242-6868",
            "fax_number": "425-831-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22620 SE 4TH ST STE 110",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980747375",
            "telephone_number": "425-242-6868",
            "fax_number": "425-831-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE PARTNERS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYECARE PARTNERS, PLLC",
        "enumeration_date": "2018-05-02",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "DALE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "425-831-2020",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "OD00003256",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2103053",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arbor Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sammamish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.