Individual provider Active NPI

Patrick Dewayne Knighton Jr., OD

  • Optometrist
  • Mukilteo, WA
National Provider Identifier
1386381184
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
61298030 Issued in WA
Practice address
8227 44TH Ave W Ste E
Mukilteo, WA 98275-2848
Phone
(860) 849-1281
Fax
(425) 382-2146
NPI assigned
May 13, 2022
Last updated
Apr 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 61298030 WA Primary

Addresses

Primary practice location

8227 44TH Ave W Ste E
Mukilteo, WA 98275-2848

Mailing address

505 Cedar Ave Ste B1
Marysville, WA 98270-4561
Phone (425) 760-1446

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
I20240625002291 WA Practitioner - Optometry 0244626273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

505 Cedar Ave
Suite B1
Marysville, WA 98270-4561
Phone (425) 760-1446

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61298030WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Knight Vision Northwest PLLC Optometrist CurrentSince Apr 26, 2024 Accepting new patients

Locations

505 Cedar Ave
Ste B1
Marysville, WA 98270
Phone (425) 405-0837

8227 44th Ave W
Ste E
Mukilteo, WA 98275
Phone (425) 347-1666

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1386381184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 CEDAR AVE STE B1",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704561",
            "telephone_number": "425-760-1446",
            "fax_number": "425-382-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8227 44TH AVE W STE E",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982752848",
            "telephone_number": "860-849-1281",
            "fax_number": "425-382-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHTON",
        "first_name": "PATRICK",
        "middle_name": "DEWAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-13",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "61298030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

Verify at the official NPI Registry.