Traci Debord Anderson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3653 Issued in WA

Practice address

3150 E 27TH Ave
# 100
Spokane, WA 99223-4919

Phone

(509) 828-4561

Fax

(509) 228-8210

NPI assigned

Aug 31, 2006

Last updated

May 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blink Eyecare PLLCGroup PAC ID 4981832847, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Blink Eyecare, PLLC

  • Optometrist
  • Spokane, WA
  • NPI 1174957161
  Medicare reassignment Care Compare group NPD
• Edith Bishel Center

  • Low Vision Rehabilitation Optometrist
  • Kennewick, WA
  • NPI 1144416298
  NPD (past)
• Edith Bishel Center for the Blind and Visually Impaired

  • Low Vision Occupational Therapist
  • Kennewick, WA
  • NPI 1104212158
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1265543045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 E 27TH AVE",
            "address_2": "# 100",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234919",
            "telephone_number": "509-991-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 E 27TH AVE",
            "address_2": "# 100",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234919",
            "telephone_number": "509-828-4561",
            "fax_number": "509-228-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TRACI",
        "middle_name": "DEBORD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029056",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Reid Anderson, OTR/L
• Stacee Anderson, PA-C
• Tamara Marie Anderson, DENTAL HYGIENIST RDH
• Terri Lynn Anderson, CERTIFIED PEER
• Tori Morgan Anderson
• Trent S Anderson, O.D.
• Vicki Anderson, MSW
• Ynah Patricia Esteban Anderson
• Yvonne Anderson, MSW
• Tanika Andoh, LMHCA

• Optometrist in Spokane, WA
• Providers in Spokane, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.