NPIMap

Organization Active NPI

Vancouver Eye Care PS

  • Ophthalmology Physician
  • Vancouver, WA
National Provider Identifier
1356375042
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
VANCOUVER EYE CARE PS
Practice address
3200 Main St
Vancouver, WA 98663-2753
Phone
(360) 696-4691
Fax
(360) 823-2260
NPI assigned
Jul 10, 2006
Last updated
Mar 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Authorized official

Name
Pamela J Huffman
Title
Administrator
Phone
(360) 823-2012

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

3200 Main St
Vancouver, WA 98663-2753

Mailing address

PO Box 61896
Vancouver, WA 98666-1896
Phone (360) 823-2012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040305000589 WA Part B Supplier - Clinic/Group Practice 5799673364 Receives reassigned benefits from 13 practitioners
Practice locations: Vancouver, WA
O20100930002226 WA DME Supplier - Physician - Ophthalmology 5799673364 Practice locations: Vancouver, WA
O20100930049816 WA DME Supplier - Physician - General SurgeryDME Supplier - Physician - Optometrist 5799673364 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vancouver, WA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3200 Main St
Vancouver, WA 98663
Phone (360) 696-4691

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1356375042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61896",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986661896",
            "telephone_number": "360-823-2012",
            "fax_number": "360-823-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MAIN ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632753",
            "telephone_number": "360-696-4691",
            "fax_number": "360-823-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCOUVER EYE CARE PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "HUFFMAN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "360-823-2012"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.