Shaun Keith Coombs, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00003477 Issued in WA

Practice address

115 New View CT NE
Olympia, WA 98506-5250

Phone

(360) 252-1642

Fax

(360) 252-1646

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 7

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, AK, OR3 enrollments

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 3

Specialty

Optometry

Education

Pacific University - College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Cataract and Laser Institute Inc PCGroup PAC ID 7517864119, shared by 15 NPIs, 75 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Bellevue, WA
  • NPI 1306013925
  Medicare reassignment NPD
• Pacific Cataract and Laser Institute of Alaska Inc PC

  • Ambulatory Surgical Clinic/Center
  • Anchorage, AK
  • NPI 1548213077
  Medicare reassignment NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Tualatin, OR
  • NPI 1265609945
  Medicare reassignment NPD
• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Chehalis, WA
  • NPI 1487821633
  NPD
• Pacific Cataract and Laser Institute Inc PC

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1659548329
  NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ophthalmologic Surgery Clinic/Center
  • Auburn, WA
  • NPI 1528814647
  NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Kennewick, WA
  • NPI 1619144607
  NPD
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Chehalis, WA
  • NPI 1114978848
  NPD (past)
• Pacific Cataract and Laser Institute, Inc., P.C.

  • Ambulatory Surgical Clinic/Center
  • Lacey, WA
  • NPI 1215178835
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1619084910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320409",
            "telephone_number": "360-242-3008",
            "fax_number": "360-807-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 NEW VIEW CT NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065250",
            "telephone_number": "360-252-1642",
            "fax_number": "360-252-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMBS",
        "first_name": "SHAUN",
        "middle_name": "KEITH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI2863",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "OPTT200",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410040792",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410040793",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "410041455",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OR",
            "identifier": "R151747",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00017913",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE AK",
            "identifier": "K162967",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00012983",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shaun.coombs.p1@direct.pcli.nextgenshare.com",
            "affiliation": "N",
            "address_1": "115 New View Ct NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacob Theodore Cook
• Jenna Lynn Cook, CDPT
• Jonathon Robert Cook, CDP-T
• Rachael Cook, LM CPM
• Tanele M Cook, ARNP
• Katrina Coons
• Nenita D Coons, RN
• Jaime Lee Cooper-Carson
• Bruce E Cooper, DDS
• Hasseltine Elizabeth Cooper, D.O.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.