Individual provider Active NPI

Brittney Melissa Gewolb, O.D.

  • Optometrist
  • Tacoma, WA
National Provider Identifier
1386096220
Registry record updated Jul 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60661206 Issued in WA
Practice address
5821 S Sprague CT # 102
Tacoma, WA 98409-6903
Phone
(253) 396-4257
NPI assigned
Jul 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60661206 WA Primary

Addresses

Primary practice location

5821 S Sprague CT # 102
Tacoma, WA 98409-6903

Mailing address

38 Lewis LN
Syosset, NY 11791-3928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161210000147 WA Practitioner - Ophthalmology 5294015145 Reassigns benefits to 1 organization
I20200701001738 NY Practitioner - Optometry 5294015145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1779 Orchard Park Rd
West Seneca, NY 14224-4624
Phone (716) 674-4110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008701NYMDRegistered Dietitian
60661206WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Sher Optical Co of Buffalo Ny Inc Optometrist CurrentSince Feb 15, 2024 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Park Sher Optical Co of Buffalo Ny Inc Optometrist Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 3, 2016 Accepting new patients
Benjamin Arthur O.D. M.S., PC Optometrist CurrentSince Mar 13, 2020 Accepting new patients
Park Sher Optical Co of Buffalo Ny Inc Optometrist CurrentSince Feb 15, 2024 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 3, 2016 Accepting new patients
Park Sher Optical Co of Buffalo Ny Inc Optometrist CurrentSince Feb 15, 2024 Accepting new patients
Park Sher Optical Co of Buffalo Ny Inc Optometrist Past Accepting new patients

Locations

3035 Genesee St
Ste 5
Cheektowaga, NY 14225
Phone (716) 896-3351

1234 Abbott Rd
Lackawanna, NY 14218
Phone (716) 272-1140

6624 Lincoln Ave
Lockport, NY 14094
Phone (716) 433-8235

950 Ridge Rd
Ste 7
Webster, NY 14580
Phone (585) 671-6630

5350 Main St
Ste 4
Williamsville, NY 14221

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

5821 S Sprague Ct
Tacoma, WA 98409
Phone (253) 396-4200

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

5821 S Sprague Ct
#102
Tacoma, WA 98409
Phone (253) 396-4257

Organizations & group practices 9

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": "1467504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467504000000",
    "number": "1386096220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 LEWIS LN",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 S SPRAGUE CT # 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096903",
            "telephone_number": "253-396-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEWOLB",
        "first_name": "BRITTNEY",
        "middle_name": "MELISSA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-03",
        "last_updated": "2016-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60661206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.