Individual provider Active NPI

Carol Ann Chou

  • Optometrist
  • Bellevue, WA
National Provider Identifier
1366061038
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61198834 Issued in WA
Practice address
4317 Factoria Blvd SE Ste a
Bellevue, WA 98006-1937
Phone
(425) 641-2020
Fax
(425) 641-7899
NPI assigned
Apr 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD61198834 WA Primary

Addresses

Primary practice location

4317 Factoria Blvd SE Ste a
Bellevue, WA 98006-1937

Mailing address

126 E 2ND St
North Bend, WA 98045-9175
Phone (217) 836-4114

Other practice location 1

126 E 2nd St
North Bend, WA 98045-9175
Phone (425) 831-2020

Other practice location 2

7726 Center Blvd SE Ste 100
Snoqualmie, WA 98065-8749
Phone (425) 831-2020

Other practice location 3

22620 SE 4th St Ste 110
Sammamish, WA 98074-7375
Phone (425) 831-2020

Other identifiers 1

IdentifierTypeStateIssuer
2188229MedicaidWA

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
I20220202001697 WA Practitioner - Optometry 2264850395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Contact Lens Consultants NorthwestGroup PAC ID 9133424369, 2 clinicians

Practice addresses (Care Compare)

4317 Factoria Blvd SE
Suite a
Bellevue, WA 98006-1937
Phone (425) 641-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD61198834WAMDOptometrist
3063OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Partners, PLLC CurrentSince Feb 25, 2022 Accepting new patients
Contact Lens Consultants Northwest CurrentSince Aug 28, 2023 Accepting new patients
Eyecare Partners, PLLC Current Accepting new patients
Eyecare Partners, PLLC CurrentSince Feb 25, 2022 Accepting new patients

Locations

4317 Factoria Blvd SE
Ste A
Bellevue, WA 98006
Phone (425) 391-3222

4317 Factoria Blvd SE
Bellevue, WA 98006

126 E 2nd St
North Bend, WA 98045
Phone (425) 831-2020

22620 SE 4th St
Ste 110
Sammamish, WA 98074
Phone (425) 242-6868

7726 Center Blvd SE
Ste 100
Snoqualmie, WA 98065
Phone (425) 831-2020

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1366061038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E 2ND ST",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980459175",
            "telephone_number": "217-836-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 FACTORIA BLVD SE STE A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061937",
            "telephone_number": "425-641-2020",
            "fax_number": "425-641-7899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "North Bend",
            "state": "WA",
            "postal_code": "980459175",
            "country_code": "US",
            "telephone_number": "425-831-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7726 Center Blvd SE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Snoqualmie",
            "state": "WA",
            "postal_code": "980658749",
            "country_code": "US",
            "telephone_number": "425-831-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22620 SE 4th St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Sammamish",
            "state": "WA",
            "postal_code": "980747375",
            "country_code": "US",
            "telephone_number": "425-831-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOU",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61198834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2188229",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.