Individual provider Active NPI

Charlene Marie Walton, O.D.

  • Optometrist
  • Seattle, WA
National Provider Identifier
1427300763
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60558068 Issued in WA
Practice address
2501 N 45TH St
Seattle, WA 98103-6909
Phone
(206) 526-5222
Fax
(206) 675-1460
NPI assigned
Oct 10, 2012
Last updated
Dec 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD60558068 WA Primary

Addresses

Primary practice location

2501 N 45TH St
Seattle, WA 98103-6909

Mailing address

2501 N 45TH St
Seattle, WA 98103-6909
Phone (206) 526-5222

Other practice location 1

2930 Maple St
Everett, WA 98201-3832
Phone (425) 261-1500

Other identifiers 1

IdentifierTypeStateIssuer
G8942686OtherWAMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

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
I20150812007663 WA Practitioner - Optometry 8426363995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2930 Maple St
Everett, WA 98201-3832
Phone (425) 261-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Puget Sound Eye Care Optometrist CurrentSince Jan 14, 2019 Accepting new patients

Locations

12402 SE 38th St
Ste 203
Bellevue, WA 98006
Phone (425) 454-0200

2930 Maple St
Everett, WA 98201
Phone (425) 261-1500

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

2501 N 45th St
Seattle, WA 98103
Phone (206) 526-5222

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: cwalton3940409@ghc.direct-ci.net

Organizations & group practices 4

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": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1427300763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N 45TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036909",
            "telephone_number": "206-526-5222",
            "fax_number": "206-675-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N 45TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036909",
            "telephone_number": "206-526-5222",
            "fax_number": "206-675-1460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2930 Maple St",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982013832",
            "country_code": "US",
            "telephone_number": "425-261-1500",
            "fax_number": "425-261-1515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTON",
        "first_name": "CHARLENE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60558068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8942686",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2930 Maple St",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982013832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.