Individual provider Active NPI

Anita S Lam, O.D.

  • Optometrist
  • Seattle, WA
National Provider Identifier
1417933250
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003728 Issued in WA
Practice address
1455 NW Leary Way
Suite 300
Seattle, WA 98107-5124
Phone
(206) 784-3350
Fax
(206) 781-8693
NPI assigned
Dec 22, 2005
Last updated
Apr 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00003728 WA Primary

Addresses

Primary practice location

1455 NW Leary Way
Suite 300
Seattle, WA 98107-5124

Mailing address

1101 Madison St
Suite 600
Seattle, WA 98104-1306
Phone (206) 215-2004

Other identifiers 3

IdentifierTypeStateIssuer
0187378OtherWALABOR & INDUSTRIES
2029080MedicaidWA
8647LAOtherREGENCE HEALTHCARE

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
I20040729001324 WA Practitioner - Optometry 7810967460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Associates Northwest PLLCGroup PAC ID 2961397385, 10 clinicians
Evergreen Eye Center PLLCGroup PAC ID 3173410057, 33 clinicians

Practice addresses (Care Compare)

1101 Madison St
Suite 600
Seattle, WA 98104-3501
Phone (206) 215-2020

1455 NW Leary Way
Suite 300
Seattle, WA 98107-5138
Phone (206) 784-3350

34719 6TH Ave S
Federal Way, WA 98003-8714
Phone (206) 212-2100

Merit-based Incentive Payment System (MIPS)

Final score
84.62 of 100Reported as group
Quality
85.07
Improvement activities
40
Cost
76.1

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Eye Center, PLLC CurrentSince Jul 7, 2004 Accepting new patients
Evergreen Eye Center, PLLC Optometrist CurrentSince Apr 8, 2024 Accepting new patients
Evergreen Eye Center, PLLC Optometrist Current Accepting new patients
Eye Associates Northwest, PLLC CurrentSince Jul 7, 2004 Accepting new patients
Evergreen Eye Center, PLLC Past Accepting new patients
310 Vision Past Accepting new patients
Evergreen Eye Center, PLLC Past Accepting new patients

Locations

34719 6th Ave S
Federal Way, WA 98003
Phone (206) 212-2100

1101 Madison St
Ste 600
Seattle, WA 98104
Phone (206) 215-2004

1455 NW Leary Way
Ste 300
Seattle, WA 98107
Phone (206) 784-3350

5300 17th Ave NW
Seattle, WA 98107
Phone (206) 783-3929

Organizations & group practices 7

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1417933250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "SUITE 600",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041306",
            "telephone_number": "206-215-2004",
            "fax_number": "206-215-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 NW LEARY WAY",
            "address_2": "SUITE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981075124",
            "telephone_number": "206-784-3350",
            "fax_number": "206-781-8693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "ANITA",
        "middle_name": "S",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0187378",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029080",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE HEALTHCARE",
            "identifier": "8647LA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.