Organization Active NPI

Island Family Eyecare, P.C.

  • Optometrist
  • Bainbridge Island, WA
National Provider Identifier
1245525336
Registry record updated Aug 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3687 Issued in WA
Legal business name
ISLAND FAMILY EYECARE, P.C.
Practice address
164 Winslow Way W
Bainbridge Island, WA 98110-2512
Phone
(206) 842-2015
Fax
(206) 842-3047
NPI assigned
Jun 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2011

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

Authorized official

Name
Dr. Scott W Brase, O.D.NPI 1265516074
Title
VP
Phone
(206) 842-2015

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3687 WA Primary

Addresses

Primary practice location

164 Winslow Way W
Bainbridge Island, WA 98110-2512

Mailing address

164 Winslow Way W
Bainbridge Island, WA 98110-2512
Phone (206) 842-2015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120507000548 WA Part B Supplier - Clinic/Group Practice 2961664024 Receives reassigned benefits from 3 practitioners
Practice locations: Bainbridge Island, WA

National Provider Directory

National Provider Directory

Locations

290 Madison Ave N
Ste 102
Bainbridge Island, WA 98110
Phone (206) 842-2015

164 Winslow Way W
Bainbridge Island, WA 98110
Phone (206) 842-2015

Practitioners & affiliated clinicians

Practitioners 3

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": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312502400000",
    "number": "1245525336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WINSLOW WAY W",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102512",
            "telephone_number": "206-842-2015",
            "fax_number": "206-842-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 WINSLOW WAY W",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102512",
            "telephone_number": "206-842-2015",
            "fax_number": "206-842-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND FAMILY EYECARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-08-05",
        "status": "A",
        "authorized_official_last_name": "BRASE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "206-842-2015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.