Pearl Eye Care Center, P.S.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1426TX Issued in WA

Legal business name

PEARL EYE CARE CENTER, P.S.

Practice address

5016 Bridgeport Way W
University Place, WA 98467-2039

Phone

(253) 472-1188

Fax

(253) 472-3594

NPI assigned

Oct 3, 2007

Organization subpart

No

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

Authorized official

Name

Michael David Noble, ODNPI 1689090102

Title

Owner

Phone

(253) 472-1188

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Pearl Eye Care Center, P.S.

  • Optometrist
  • Tukwila, WA
  • NPI 1215675442

  O20040726001371

  Same enrollment
• Pearl Eyecare Center P S

  • Optometrist
  • Puyallup, WA
  • NPI 1174294870

  O20040726001371

  Same enrollment

Tax ID family

Pearl Eye Care Center PS3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Pearl Eye Care Center, P.S.

  • Optometrist
  • Tukwila, WA
  • NPI 1215675442
  NPD tax ID
• Pearl Eyecare Center P S

  • Optometrist
  • Puyallup, WA
  • NPI 1174294870
  NPD tax ID

Locations

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.

• Pearl Eye Care Center, P.S.

  • Optometrist
  • Tukwila, WA
  • NPI 1215675442
  NPPES parent name

Practitioners 3

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

• Michael David Noble, O.D.

  • Optometrist
  • Tacoma, WA
  • NPI 1689090102
  Medicare reassignment Care Compare group Authorized official
• Christopher Inman Clark, OD

  • Optometrist
  • Seattle, WA
  • NPI 1265461594
  Medicare reassignment Care Compare group NPD
• Alma Leoneli Fuentes, OD

  • Optometrist
  • Long Beach, CA
  • NPI 1316493158

  WA

  Medicare reassignment

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1376730382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 S 38TH ST STE A108",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097372",
            "telephone_number": "253-472-1188",
            "fax_number": "253-472-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984672039",
            "telephone_number": "253-472-1188",
            "fax_number": "253-472-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL EYE CARE CENTER, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "NOBLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-472-1188",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1426TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2003416",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Lee Parkes, MA, JD
• Aryanna Paterson
• Jeffrey D Patterson, MD
• Marilyn E Pattison, MD
• Pearl Chiropractic, P S
• Yining Peng
• Emelie Pennington-Davis
• Heather Rae Penny, AAC, CPC
• Raphael U Peralta, MD
• Ashley Marie Perez Soto

• Optometrist in University Place, WA
• Providers in University Place, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.