Organization Active NPI

Retina Consultants of Seattle, PC

  • Specialist
  • Seattle, WA
National Provider Identifier
1467566828
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
RETINA CONSULTANTS OF SEATTLE, PC
Practice address
1530 N 115TH St
Suite 105
Seattle, WA 98133-8411
Phone
(206) 363-7035
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Mrs. Kris Stolmeier, M.S.
Title
Administrator
Phone
(206) 363-7035

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1530 N 115TH St
Suite 105
Seattle, WA 98133-8411

Mailing address

1530 N 115TH St
Suite 105
Seattle, WA 98133-8411
Phone (206) 363-7035

Other identifiers 1

IdentifierTypeStateIssuer
8114357MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040726001475 WA Part B Supplier - Clinic/Group Practice 3072583327 Receives reassigned benefits from 4 practitioners
Practice locations: Bellevue, WA; Everett, WA; Seattle, WA

National Provider Directory

National Provider Directory

Locations

1370 116th Ave NE
Ste 110
Bellevue, WA 98004
Phone (206) 628-2020

1530 N 115th St
Ste 105
Seattle, WA 98133
Phone (206) 363-7035

Interoperability endpoints

  • Direct secure messaging: songchin@rcseattle.intellechartdirect.net
  • Direct secure messaging: swarden@rcseattle.intellechartdirect.net
  • Direct secure messaging: ddrucker@rcseattle.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1467566828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 N 115TH ST",
            "address_2": "SUITE 105",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338411",
            "telephone_number": "206-363-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N 115TH ST",
            "address_2": "SUITE 105",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338411",
            "telephone_number": "206-363-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA CONSULTANTS OF SEATTLE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "STOLMEIER",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "206-363-7035",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8114357",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.