Mariann Jean Tonder, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00003052 Issued in WA

Practice address

19220 8TH Ave NE Ste a
Poulsbo, WA 98370-8773

Phone

(360) 779-2336

Fax

(360) 779-7628

NPI assigned

Aug 29, 2006

Sex

Female

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 4

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

Southern California College of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kitsap Eyecare Centers Inc PSGroup PAC ID 2264320894, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Kitsap Eyecare Centers Inc PS

  dba Poulsbo Eyecare Center

  • Optometrist
  • Poulsbo, WA
  • NPI 1477612463
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1376652198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19220 8TH AVE NE STE A",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708773",
            "telephone_number": "360-779-2336",
            "fax_number": "360-779-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19220 8TH AVE NE STE A",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708773",
            "telephone_number": "360-779-2336",
            "fax_number": "360-779-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONDER",
        "first_name": "MARIANN",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015782",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS HEALTH PLANS",
            "identifier": "91155102308",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "T02279",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "26185",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.