NPIMap

Organization Active NPI

Future Vision Partners, Inc

Doing business as Deer Park Vision

  • Corneal and Contact Management Optometrist
  • Deer Park, WA
National Provider Identifier
1285790659
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
1538TX Issued in WA
Legal business name
FUTURE VISION PARTNERS, INC
Doing business as
Deer Park Vision
Practice address
26 W H St
Suite a
Deer Park, WA 99006-7167
Phone
(509) 276-6932
Fax
(509) 276-1608
NPI assigned
Dec 29, 2006
Last updated
Jan 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Authorized official

Name
Dr. Michael Kalani De Rosier, ODNPI 1518960954
Title
President
Phone
(509) 276-6932

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
Corneal and Contact Management Optometrist 152WC0802X 1538TX WA Primary

Addresses

Primary practice location

26 W H St
Suite a
Deer Park, WA 99006-7167

Mailing address

26 W H St
Suite a
Deer Park, WA 99006-7167
Phone (509) 276-6932

Other identifiers 1

IdentifierTypeStateIssuer
2025153MedicaidWA

Other names 1

  • Deer Park Vision Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040305000304 WA Part B Supplier - Clinic/Group Practice 2365330099 Receives reassigned benefits from 5 practitioners
Practice locations: Deer Park, WA
O20100930095991 WA DME Supplier - Physician - Optometrist 2365330099 Practice locations: Deer Park, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Future Vision Partners Inc26 W H St, Deer Park, WA 99006-7167(509) 276-6932 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Aug 15, 2001

National Provider Directory

National Provider Directory

Locations

206 W 1st St
Deer Park, WA 99006
Phone (509) 276-6932

26 W H St
Deer Park, WA 99006
Phone (509) 276-6932

26 W H St
Ste A
Deer Park, WA 99006
Phone (509) 276-6732

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1285790659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 W H ST",
            "address_2": "SUITE A",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990067167",
            "telephone_number": "509-276-6932",
            "fax_number": "509-276-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 W H ST",
            "address_2": "SUITE A",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990067167",
            "telephone_number": "509-276-6932",
            "fax_number": "509-276-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUTURE VISION PARTNERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "DE ROSIER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KALANI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-276-6932",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "1538TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2025153",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deer Park Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deer Park, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.