Jon Charles Converse, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3170TX Issued in WA

Practice address

10516 Silverdale Way NW Ste 104
Silverdale, WA 98383-8745

Phone

(360) 307-7400

NPI assigned

Nov 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jconverse13256@ghc.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment Care Compare group NPD
• Jon C Converse Inc PS

  dba Binyon Eye Care

  • Optometrist
  • Seattle, WA
  • NPI 1699841361
  NPD (past) Authorized official
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Kaiser Foundation Health Plan of Washington

  dba Silverdale Way Office Building

  • Multi-Specialty Clinic/Center
  • Silverdale, WA
  • NPI 1356632459
  NPD (past)
• Specialty Eyecare Group Inc

  dba Totem Lake Vision Center

  • Optometrist
  • Kirkland, WA
  • NPI 1235317637
  NPD (past)

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1356523807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10516 SILVERDALE WAY NW STE 104",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838745",
            "telephone_number": "360-307-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10516 SILVERDALE WAY NW STE 104",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838745",
            "telephone_number": "360-307-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1905 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981011106",
            "country_code": "US",
            "telephone_number": "206-622-8247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONVERSE",
        "first_name": "JON",
        "middle_name": "CHARLES",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-27",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3170TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019263",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10516 Silverdale Way NW Ste 104",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983838745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teresa Diane Collett, PSY.D.
• Mharie Lee Collins
• Commonspirit Washington Community Care (St Michael Medical Center)
• Emily Kathleen Comstock
• David R Congdon, MD
• Peter Cooper
• Costco Wholesale Corporation
• Costco Wholesale Corporation (Costco Hearing Aid #13)
• Costco Wholesale Corporation (Costco Optical #13)
• Kristina Cotant

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.