Individual provider Active NPI

Bruce E Wietharn, M.D.

  • Ophthalmology Physician
  • Arlington, WA
National Provider Identifier
1255420782
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD00043436 Issued in WA
Practice address
903 Medical Center Dr
Arlington, WA 98223-1697
Phone
(360) 435-8595
Fax
(360) 435-5233
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD00043436 WA Primary

Addresses

Primary practice location

903 Medical Center Dr
Arlington, WA 98223-1697

Mailing address

903 Medical Center Dr
Arlington, WA 98223-1697
Phone (360) 435-8595

Other identifiers 1

IdentifierTypeStateIssuer
8389991MedicaidWA

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040602001351 WA Practitioner - Ophthalmology 4082696158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Tulane University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sight Partners Physicians PCGroup PAC ID 6002728532, 59 clinicians

Practice addresses (Care Compare)

903 Medical Ctr Dr
Suite 100
Arlington, WA 98223-2600
Phone (360) 435-8595

Merit-based Incentive Payment System (MIPS)

Final score
89.74 of 100Reported as group
Quality
88.73
Promoting interoperability
100
Improvement activities
40
Cost
77.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00043436WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sight Partners Physicians, P.C. Ophthalmology CurrentSince Dec 16, 2020 Accepting new patients
Sight Partners Physicians PC CurrentSince Dec 16, 2020 Accepting new patients
Sight Partners Physicians, P.C. Ophthalmology Past Accepting new patients
Sight Partners Physicians, P.C. Ophthalmology Past Accepting new patients
Sight Partners Physicians, P.C. Ophthalmology Past Accepting new patients
Sight Partners Physicians, P.C. Ophthalmology Past Accepting new patients
Jules Stein Eye Institute Medical Group Past Accepting new patients

Locations

16404 Smokey Point Blvd
Ste 303
Arlington, WA 98223
Phone (360) 658-6224

903 Medical Center Dr
Ste 100
Arlington, WA 98223
Phone (360) 435-8595

2075 Barkley Blvd
Ste 205
Bellingham, WA 98226
Phone (360) 676-6233

21906 76th Ave W
Edmonds, WA 98026
Phone (425) 577-4262

1306 Roosevelt Ave
Mount Vernon, WA 98273
Phone (360) 428-2020

1412 SW 43rd St
Ste 310
Renton, WA 98057
Phone (425) 235-1200

332 NE Northgate Way
Seattle, WA 98125

795 N 5th Ave
Sequim, WA 98382
Phone (360) 658-6224

16010 E Indiana Ave
Spokane Valley, WA 99216
Phone (509) 928-8040

Interoperability endpoints

  • Direct secure messaging: bwietharn45125@skagit.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1255420782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 MEDICAL CENTER DR",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231697",
            "telephone_number": "360-435-8595",
            "fax_number": "360-435-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 MEDICAL CENTER DR",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231697",
            "telephone_number": "360-435-8595",
            "fax_number": "360-435-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETHARN",
        "first_name": "BRUCE",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00043436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8389991",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

Verify at the official NPI Registry.