Individual provider Active NPI

Kimberly Skyles, O.D.

  • Optometrist
  • Redmond, WA
National Provider Identifier
1477906485
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60667876 Issued in WA
Practice address
12377 137TH PL NE Unit 130
Redmond, WA 98052-2232
Phone
(425) 885-3574
NPI assigned
Jul 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X 60667876 WA
Optometrist 152W00000X 60667876 WA Primary

Addresses

Primary practice location

12377 137TH PL NE Unit 130
Redmond, WA 98052-2232

Mailing address

12377 137TH PL NE Unit 130
Redmond, WA 98052-2232
Phone (425) 885-3574

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
I20170508000595 WA Practitioner - Optometry 9931486651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeff Binstock DVM OD Faao PLLCGroup PAC ID 3971863507, 2 clinicians

Practice addresses (Care Compare)

12377 137TH PL NE
Redmond, WA 98052-2232
Phone (425) 885-3574

16150 NE 85TH St
Suite 206
Redmond, WA 98052-3543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60667876WAMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Optometry LLC Optometrist CurrentSince Jan 1, 2018 Accepting new patients

Locations

16150 NE 85th St
Ste 206
Redmond, WA 98052
Phone (425) 885-3574

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": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1477906485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12377 137TH PL NE UNIT 130",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522232",
            "telephone_number": "425-885-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12377 137TH PL NE UNIT 130",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522232",
            "telephone_number": "425-885-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKYLES",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "WA",
            "license": "60667876",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60667876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.