Individual provider Active NPI

Anna Marie Gunn, O.D.

  • Optometrist
  • University Place, WA
National Provider Identifier
1295015832
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60223150 Issued in WA
Practice address
5225 Cirque Dr W
Suite 200
University Place, WA 98467-3604
Phone
(253) 848-3000
Fax
(253) 845-8750
NPI assigned
Aug 26, 2011
Last updated
Mar 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60223150 WA Primary

Addresses

Primary practice location

5225 Cirque Dr W
Suite 200
University Place, WA 98467-3604

Mailing address

1703 S Meridian
Suite 101
Puyallup, WA 98371-7590
Phone (253) 838-3000

Other identifiers 1

IdentifierTypeStateIssuer
2016615MedicaidWA

Other names 1

  • Anna Marie Luebbers Former name

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
I20120507000255 WA Practitioner - Optometry 0749442879 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Care Associates PLLCGroup PAC ID 9739181728, 2 clinicians

Practice addresses (Care Compare)

8204 27TH W St
University Place, WA 98466-2719
Phone (253) 564-9262

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60223150WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Care Associates PLLC Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Bridgeport Family Vision Clinic, PLLC Optometrist CurrentSince Sep 7, 2021 Accepting new patients
Vision Care Associates PLLC Optometrist CurrentSince Jul 1, 2023 Accepting new patients
David Thomas Williams Optometrist PastSince Sep 7, 2021 Accepting new patients

Locations

9101 Bridgeport Way SW
Ste C
Tacoma, WA 98499
Phone (206) 588-2254

8204 27th St W
University Place, WA 98466
Phone (206) 564-9262

207 Yelm Ave W
Yelm, WA 98597
Phone (360) 458-2088

Interoperability endpoints

  • Direct secure messaging: a.gunn@cascade.emadirect.md

Organizations & group practices 4

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": "1314316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1295015832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN",
            "address_2": "SUITE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-838-3000",
            "fax_number": "253-845-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 CIRQUE DR W",
            "address_2": "SUITE 200",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984673604",
            "telephone_number": "253-848-3000",
            "fax_number": "253-845-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNN",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-26",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60223150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016615",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA MARIE",
            "last_name": "LUEBBERS",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in University Place, WA

Sources for this page

Verify at the official NPI Registry.