Individual provider Active NPI

Robin D Gouin, O.D.

  • Optometrist
  • Redmond, WA
National Provider Identifier
1558696203
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60100047 Issued in WA
Practice address
8630 164TH Ave NE
Suite 100
Redmond, WA 98052-3606
Phone
(425) 885-7363
Fax
(425) 861-5585
NPI assigned
Oct 14, 2009
Last updated
Apr 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD60100047 WA Primary

Addresses

Primary practice location

8630 164TH Ave NE
Suite 100
Redmond, WA 98052-3606

Mailing address

8630 164TH Ave NE Ste 100
Redmond, WA 98052-3606
Phone (425) 885-7363

Other identifiers 1

IdentifierTypeStateIssuer
1558696203MedicaidWA

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
I20100910000064 WA Practitioner - Optometry 6608991930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redmond Eye Doctors, PLLCGroup PAC ID 3577567379, 3 clinicians

Practice addresses (Care Compare)

8630 164TH Ave NE
Suite 100
Redmond, WA 98052-1906
Phone (425) 885-7363

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Redmond Eye Doctors, PLLC Optometrist CurrentSince Jun 10, 2011 Accepting new patients

Locations

8630 164th Ave NE
#100
Redmond, WA 98052
Phone (425) 885-7363

8630 164th Ave NE
Ste 100
Redmond, WA 98052
Phone (425) 885-7363

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, 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": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1558696203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 164TH AVE NE STE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523606",
            "telephone_number": "425-885-7363",
            "fax_number": "425-861-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8630 164TH AVE NE",
            "address_2": "SUITE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523606",
            "telephone_number": "425-885-7363",
            "fax_number": "425-861-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUIN",
        "first_name": "ROBIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-14",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60100047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558696203",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.