NPIMap

Organization Active NPI

Advanced Family Eye Care of Duvall

  • Optometrist
  • Duvall, WA
National Provider Identifier
1306229760
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60351798 Issued in WA
Legal business name
ADVANCED FAMILY EYE CARE OF DUVALL
Practice address
14610 Main St NE
Suite 101
Duvall, WA 98019-8469
Phone
(425) 788-2990
Fax
(425) 650-9896
NPI assigned
Jul 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Fiona Bryant
Title
Office Manager
Phone
(425) 788-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD60351798 WA Primary

Addresses

Primary practice location

14610 Main St NE
Suite 101
Duvall, WA 98019-8469

Mailing address

14610 Main St NE
Suite 101
Duvall, WA 98019-8469
Phone (425) 788-2990

Other names 1

  • Duvall Advanced Family Eye Care Doing business as

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151006003150 WA Part B Supplier - Clinic/Group Practice 9234447517 Receives reassigned benefits from 2 practitioners
Practice locations: Duvall, WA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1306229760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14610 MAIN ST NE",
            "address_2": "SUITE 101",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980198469",
            "telephone_number": "425-788-2990",
            "fax_number": "425-276-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14610 MAIN ST NE",
            "address_2": "SUITE 101",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980198469",
            "telephone_number": "425-788-2990",
            "fax_number": "425-650-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY EYE CARE OF DUVALL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-02",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "FIONA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-788-2990"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60351798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duvall Advanced Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Duvall Advanced Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duvall, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.