Individual provider Active NPI

Jennifer Weaver-Farnam, O.D.

  • Optometrist
  • Burien, WA
National Provider Identifier
1508961251
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1753 TX Issued in WA
Practice address
401 SW 153Rd St
Suite a
Burien, WA 98166-2247
Phone
(206) 244-1780
Fax
(206) 433-4060
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1753 TX WA Primary

Addresses

Primary practice location

401 SW 153Rd St
Suite a
Burien, WA 98166-2247

Mailing address

401 SW 153Rd St
Suite a
Burien, WA 98166-2247
Phone (206) 244-1780

Other identifiers 1

IdentifierTypeStateIssuer
2023422MedicaidWA

Other names 1

  • Dr. Jennifer Weaver Farnam Other name

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
I20051222000672 WA Practitioner - Optometry 9032131602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Binyon Vision Center, Inc.Group PAC ID 7012061369, 2 clinicians

Practice addresses (Care Compare)

401 SW 153Rd St
Suite a
Burien, WA 98166-2247
Phone (206) 244-1780

401 Sw153Rd St
Burien, WA 98166-2247

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1753 TXWAMDOptometrist

Organizations & group practices 1

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1508961251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 SW 153RD ST",
            "address_2": "SUITE A",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662247",
            "telephone_number": "206-244-1780",
            "fax_number": "206-433-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SW 153RD ST",
            "address_2": "SUITE A",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662247",
            "telephone_number": "206-244-1780",
            "fax_number": "206-433-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER-FARNAM",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1753 TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2023422",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FARNAM",
            "middle_name": "WEAVER",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.