Individual provider Active NPI

Erick H Auyoung, O.D.

  • Optometrist
  • McChord Afb, WA
National Provider Identifier
1255445623
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3940 Issued in WA
Practice address
504 Barnes Blvd
McChord Afb, WA 98438-1304
Phone
(253) 588-1731
Fax
(253) 588-1741
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3940 WA Primary

Addresses

Primary practice location

504 Barnes Blvd
McChord Afb, WA 98438-1304

Mailing address

608 39TH Ave SW Apt D305
Puyallup, WA 98373-5908
Phone (253) 445-7963

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051219000493 WA Practitioner - Optometry 8628090610 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3940WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kyle Sexton, O.D., LLC Optometrist CurrentSince Dec 29, 2014 Accepting new patients

Locations

3500 S Meridian
Ste 926
Puyallup, WA 98373
Phone (253) 864-9350

Organizations & group practices 2

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1255445623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 39TH AVE SW APT D305",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735908",
            "telephone_number": "253-445-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 BARNES BLVD",
            "city": "MCCHORD AFB",
            "state": "WA",
            "postal_code": "984381304",
            "telephone_number": "253-588-1731",
            "fax_number": "253-588-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUYOUNG",
        "first_name": "ERICK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McChord Afb, WA

Sources for this page

Verify at the official NPI Registry.