Individual provider Active NPI

Janice Pandora Ngan, O.D.

  • Optometrist
  • Bellevue, WA
National Provider Identifier
1437196789
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4002TX Issued in WA
Practice address
10218 NE 8TH St
Bellevue, WA 98004-4294
Phone
(425) 455-4602
Fax
(425) 709-6879
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4002TX WA Primary

Addresses

Primary practice location

10218 NE 8TH St
Bellevue, WA 98004-4294

Mailing address

1580 Woodridge Dr SE
Port Orchard, WA 98366-3818
Phone (360) 871-7837

Other identifiers 1

IdentifierTypeStateIssuer
2023174MedicaidWA

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
I20120320000194 WA Practitioner - Optometry 1355501990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1580 Woodridge Dr SE
Port Orchard, WA 98366-3818
Phone (360) 871-7837

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4002TXWAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
J & J Optometric Services Optometrist CurrentSince Mar 8, 2017 Accepting new patients
Doctors McGrath & Brooke, PS Optometrist PastSince Mar 8, 2017 Accepting new patients

Locations

1580 Woodridge Dr SE
Port Orchard, WA 98366
Phone (360) 871-7837

4854 Rainier Ave S
Seattle, WA 98118
Phone (206) 619-2084

Organizations & group practices 2

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1437196789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 WOODRIDGE DR SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663818",
            "telephone_number": "360-871-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10218 NE 8TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044294",
            "telephone_number": "425-455-4602",
            "fax_number": "425-709-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGAN",
        "first_name": "JANICE",
        "middle_name": "PANDORA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "4002TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2023174",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.