Individual provider Active NPI

Amber M Cumings, OD

  • Pediatric Optometrist
  • Redmond, WA
National Provider Identifier
1528553450
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
OD60855608 Issued in WA
Practice address
17130 Avondale Way NE Ste 111
Redmond, WA 98052-4455
Phone
(425) 885-6600
NPI assigned
Jun 23, 2018
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60855608 WA
Pediatric Optometrist 152WP0200X OD60855608 WA Primary

Addresses

Primary practice location

17130 Avondale Way NE Ste 111
Redmond, WA 98052-4455

Mailing address

12333 NE 130TH LN Ste 440
Kirkland, WA 98034-7467
Phone (425) 885-6600

Other identifiers 2

IdentifierTypeStateIssuer
2241184MedicaidWA
463729OtherWAWA L&I

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
I20230627002489 WA Practitioner - Optometry 5395074819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

17130 Avondale Way NE
Suite 111
Redmond, WA 98052-4455
Phone (425) 885-6600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60855608WAMDOptometrist
OD60855608WAMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jul 10, 2023 Accepting new patients
Proliance Surgeons, Inc., P.S. Optometrist CurrentSince Jul 10, 2023 Accepting new patients
Proliance Surgeons Inc., P.S. Past Accepting new patients

Locations

1800 116th Ave NE
Ste 102
Bellevue, WA 98004
Phone (425) 451-3710

12333 NE 130th Ln
Ste 440
Kirkland, WA 98034
Phone (425) 885-6600

17130 Avondale Way NE
Ste 111
Redmond, WA 98052
Phone (425) 885-6600

8301 161st Ave NE
Ste 200
Redmond, WA 98052
Phone (425) 869-4855

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: amanda.cumings.p70@direct.proliance.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1528553450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12333 NE 130TH LN STE 440",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347467",
            "telephone_number": "425-885-6600",
            "fax_number": "425-885-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17130 AVONDALE WAY NE STE 111",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980524455",
            "telephone_number": "425-885-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMINGS",
        "first_name": "AMBER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-23",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60855608",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "WA",
            "license": "OD60855608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2241184",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "463729",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.