Individual provider Active NPI

Scott W Brase, O.D.

  • Optometrist
  • Bainbridge Island, WA
National Provider Identifier
1265516074
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3687 Issued in WA
Practice address
164 Winslow Way W
Bainbridge Island, WA 98110-2512
Phone
(206) 842-2015
Fax
(206) 842-3047
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 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
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
I20120507000601 WA Practitioner - Optometry 2769644830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Family Eyecare, P.C.Group PAC ID 2961664024, 3 clinicians

Practice addresses (Care Compare)

164 Winslow Way W
Bainbridge Island, WA 98110-2512

290 Madison Ave N
Suite 102
Bainbridge Island, WA 98110-3048
Phone (206) 842-2015

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3687WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Island Family Eyecare, P.C. Optometrist CurrentSince Sep 11, 2018 Accepting new patients

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

Interoperability endpoints

  • Direct secure messaging: scott.brase@direct.revolutionehr.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265516074",
    "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": {
        "last_name": "BRASE",
        "first_name": "SCOTT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

Verify at the official NPI Registry.