Organization Active NPI

Optix Eyewear, Inc

  • Optometrist
  • Redmond, WA
National Provider Identifier
1609046101
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1077TX Issued in WA
Legal business name
OPTIX EYEWEAR, INC
Practice address
16560 NE 74TH St
Redmond, WA 98052-7804
Phone
(425) 558-4500
Fax
(425) 895-9520
NPI assigned
Mar 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Dr. Robert B Collins, OD
Title
Ceo
Phone
(425) 558-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1077TX WA Primary

Addresses

Primary practice location

16560 NE 74TH St
Redmond, WA 98052-7804

Mailing address

16560 NE 74TH St
Redmond, WA 98052-7804
Phone (425) 558-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050127000710 WA Part B Supplier - Clinic/Group Practice 9537119466 Receives reassigned benefits from 1 practitioner
Practice locations: Redmond, WA

National Provider Directory

National Provider Directory

Locations

7425 166th Ave NE
Ste C220
Redmond, WA 98052
Phone (425) 558-4500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1609046101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16560 NE 74TH ST",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980527804",
            "telephone_number": "425-558-4500",
            "fax_number": "425-895-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16560 NE 74TH ST",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980527804",
            "telephone_number": "425-558-4500",
            "fax_number": "425-895-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIX EYEWEAR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-558-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1077TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.