Individual provider Active NPI

Stephanie J He

  • Optometrist
  • Monroe, WA
National Provider Identifier
1417452921
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34208TLG Issued in CA
Practice address
14841 179TH Ave SE Ste 110
Monroe, WA 98272-1127
Phone
(360) 794-2020
NPI assigned
Mar 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 34208TLG CA Primary

Addresses

Primary practice location

14841 179TH Ave SE Ste 110
Monroe, WA 98272-1127

Mailing address

14841 179TH Ave SE Ste 110
Monroe, WA 98272-1127
Phone (360) 794-2020

Other practice location 1

16111 Plummer St
North Hills, CA 91343-2036
Phone (818) 891-7711

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
I20200203001042 WA Practitioner - Optometry 6709212178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monroe Vision Clinic IncGroup PAC ID 5890686083, 5 clinicians

Practice addresses (Care Compare)

14841 179TH Ave SE
Suite 110
Monroe, WA 98272-1127
Phone (360) 794-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34208TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe Vision Clinic, Inc Optometrist CurrentSince Feb 1, 2021 Accepting new patients
Specialty Eyecare Group Inc Optometrist CurrentSince Jan 2, 2020 Accepting new patients
Northwest Vision Consultants PastSince Jan 2, 2020 Accepting new patients

Locations

225 106th Ave NE
Bellevue, WA 98004
Phone (425) 454-2028

11830 NE 128th St
Ste 1
Kirkland, WA 98034
Phone (425) 814-8900

14841 179th Ave SE
Ste 110
Monroe, WA 98272
Phone (360) 794-2020

1924 Bickford Ave
Ste 201
Snohomish, WA 98290
Phone (360) 794-2020

Organizations & group practices 3

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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1417452921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 179TH AVE SE STE 110",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721127",
            "telephone_number": "360-794-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14841 179TH AVE SE STE 110",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721127",
            "telephone_number": "360-794-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16111 Plummer St",
            "address_purpose": "LOCATION",
            "city": "North Hills",
            "state": "CA",
            "postal_code": "913432036",
            "country_code": "US",
            "telephone_number": "818-891-7711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HE",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34208TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, WA

Sources for this page

Verify at the official NPI Registry.