Individual provider Active NPI

Cory James Jensen, OD

  • Optometrist
  • Spokane, WA
National Provider Identifier
1417516279
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60965247 Issued in WA
Practice address
601 W Francis Ave
Spokane, WA 99205-6699
Phone
(509) 326-2772
NPI assigned
Jun 6, 2019
Last updated
Jun 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD60965247 WA Primary

Addresses

Primary practice location

601 W Francis Ave
Spokane, WA 99205-6699

Mailing address

52031 Eagle View LN
Ford, WA 99013-9517
Phone (509) 844-5605

Other identifiers 1

IdentifierTypeStateIssuer
JENSECJ102N2OtherWADRIVER LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190717002648 WA Practitioner - Optometry 4789919440 Reassigns benefits to 2 organizations
I20210114001921 SC Practitioner - Optometry 4789919440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Provider Enterprise LLCGroup PAC ID 0840458667, 8 clinicians
Eye Consultants, P.S.Group PAC ID 8628143492, 6 clinicians

Practice addresses (Care Compare)

135 S 336TH St
Federal Way, WA 98003-6350
Phone (253) 835-7433

9911 N Nevada St
Suite B
Spokane, WA 99218-1298
Phone (509) 484-5710

Merit-based Incentive Payment System (MIPS)

Final score
88.35 of 100Reported as group
Quality
91.67
Improvement activities
40
Cost
72.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OD60965247WAMDOptometrist
2243SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Eye Care, LLC Optometrist CurrentSince Jan 11, 2021 Accepting new patients
Professional Provider Enterprise LLC Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Eye Consultants, P.S. CurrentSince Aug 1, 2021 Accepting new patients
Eye Consultants, P.S. PastSince Apr 27, 2025 Accepting new patients
Eye Consultants PS Past Accepting new patients

Locations

10826 Old Mill Rd
Ste 101
Omaha, NE 68154

220 E Hereford St
Gladstone, OR 97027
Phone (503) 656-0393

317 Ruth Vista Rd
Lexington, SC 29073
Phone (803) 714-3665

3131 Newberry Hwy
Saluda, SC 29138
Phone (800) 898-3232

2235 Lake Heights Dr
Everett, WA 98208
Phone (425) 338-3000

916 Pacific Ave
Everett, WA 98201
Phone (425) 258-7123

135 S 336th St
Federal Way, WA 98003
Phone (253) 835-7433

9911 N Nevada St
Ste B
Spokane, WA 99218
Phone (509) 484-5710

15106 E Sprague Ave
Spokane Valley, WA 99037
Phone (509) 484-5710

Interoperability endpoints

  • Direct secure messaging: jensen@eyeconsultantsnw.emadirect.md

Organizations & group practices 5

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": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1417516279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52031 EAGLE VIEW LN",
            "city": "FORD",
            "state": "WA",
            "postal_code": "990139517",
            "telephone_number": "509-844-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W FRANCIS AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056699",
            "telephone_number": "509-326-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CORY",
        "middle_name": "JAMES",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60965247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "JENSECJ102N2",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.