Individual provider Active NPI

Michael Venedict Osetinsky, MD

  • Ophthalmology Physician
  • Everett, WA
National Provider Identifier
1407920440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Practice address
1724 West Marine View Drive
Suite 130
Everett, WA 98201-2088
Phone
(425) 252-2333
Fax
(425) 252-3359
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X WA Primary

Addresses

Primary practice location

1724 West Marine View Drive
Suite 130
Everett, WA 98201-2088

Mailing address

1724 West Marine View Drive
Suite 130
Everett, WA 98201-2088
Phone (425) 252-2333

Other identifiers 1

IdentifierTypeStateIssuer
1110873MedicaidWA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100205000334 WA Practitioner - Ophthalmology 0042353526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1724 W Marine View Dr
Suite 130
Everett, WA 98201-2088
Phone (425) 252-2333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD000029567WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Washington Eye Specialists Ophthalmology CurrentSince Jun 17, 2000 Accepting new patients

Locations

1724 W Marine View Dr
Everett, WA 98201
Phone (425) 252-2333

1724 W Marine View Dr
Ste 130
Everett, WA 98201
Phone (425) 252-2333

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407920440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 WEST MARINE VIEW DRIVE",
            "address_2": "SUITE 130",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012088",
            "telephone_number": "425-252-2333",
            "fax_number": "425-252-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 WEST MARINE VIEW DRIVE",
            "address_2": "SUITE 130",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012088",
            "telephone_number": "425-252-2333",
            "fax_number": "425-252-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSETINSKY",
        "first_name": "MICHAEL",
        "middle_name": "VENEDICT",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1110873",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.