Eyekea Vision Center LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

OD60213875 Issued in WA

Legal business name

EYEKEA VISION CENTER LLC

Practice address

4051 Tacoma Mall Blvd
Tacoma, WA 98409-7287

Phone

(253) 476-2874

NPI assigned

Feb 25, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Diana Nguyen, O.D.NPI 1013213123

Title

Optometric Physician

Phone

(253) 476-2874

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana H. P. Nguyen, O.D.

  • Optometrist
  • Tacoma, WA
  • NPI 1013213123
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1447590674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 TACOMA MALL BLVD",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 TACOMA MALL BLVD",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097287",
            "telephone_number": "253-476-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEKEA VISION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OPTOMETRIC PHYSICIAN",
        "authorized_official_telephone_number": "253-476-2874",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "OD60213875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Meagan Ann Eyster, PNP
• Elizabeth A Ezell, LICSW

• Preferred Provider Organization in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Preferred Provider Organization in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.