Judy Quach, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD61051669 Issued in WA

Practice address

2316 Eastgate St Ste 170
Walla Walla, WA 99362-1576

Phone

(509) 529-7371

NPI assigned

Nov 24, 2019

Last updated

Jul 7, 2020By 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 2

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

Southern California College of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Source Walla Walla PLLCGroup PAC ID 0143752576, 3 clinicians

Practice addresses (Care Compare)

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.

• Vision Source Walla Walla PLLC

  • Optometrist
  • Walla Walla, WA
  • NPI 1245077080
  Medicare reassignment Care Compare group
• Nielson Eye Care

  • Optometrist
  • Walla Walla, WA
  • NPI 1922366327
  Medicare reassignment NPD

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

{
    "created_epoch": "1574553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1598301616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 EASTGATE ST STE 170",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621576",
            "telephone_number": "480-370-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 EASTGATE ST STE 170",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621576",
            "telephone_number": "509-529-7371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5001 W Waco Dr",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767107021",
            "country_code": "US",
            "telephone_number": "480-370-9917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUACH",
        "first_name": "JUDY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-24",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9618",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61051669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Health & Services - Washington (Providence Medical Group Southeast Washington)
• Providence Health & Services - Washington
• Providence Health & Services - Washington (Providence Medical Group Southeast Washington Radiation Oncology)
• Jeffrey M Pryor, D.O.
• Sheena Pursley, MSW, LSWAIC
• Robert C Quackenbush, M.D.
• Qualicenters Inland Northwest L.L.C. (Qualicenters Walla Walla)
• Dana Rabourne
• Judith Raboy, NP
• Alissa N Ralston, ARNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.