Elisha M Fog, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD61562432 Issued in WA

Practice address

677 S Jackson St
Seattle, WA 98104-2928

Phone

(206) 623-1100

NPI assigned

Jun 30, 2023

Last updated

Sep 10, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seattle Vision Clinic IncGroup PAC ID 7517856222, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Seattle Vision Clinic Inc

  • Optometrist
  • Seattle, WA
  • NPI 1518955202
  Medicare reassignment Care Compare group NPD
• Everett Optometry Clinic, PLLC

  • Optometrist
  • Everett, WA
  • NPI 1760601488
  NPD (past)

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1487331351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014911",
            "telephone_number": "425-252-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 S JACKSON ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042928",
            "telephone_number": "206-623-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 Colby Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014911",
            "country_code": "US",
            "telephone_number": "425-252-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOG",
        "first_name": "ELISHA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61562432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Focht, MD
• Callan Elswick Fockele, M.D.
• Bethany Foelber, MA, LMHC
• Jocelyn Angela Fofana, ARNP
• Anita Estelle Fofie, M.D.
• Theodora A Fogarty, LMP
• Jane Ann Fogdall, RN, IBCLC
• Anna Levu Fogel, RD
• Elise Linehan Fogel, CNM, ARNP
• Johri Fogerson, LMP

• Optometrist in Seattle, WA
• Providers in Seattle, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.