Individual provider Active NPI

Phoebe Gayoso, OD

  • Optometrist
  • Seattle, WA
National Provider Identifier
1639817729
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61318732 Issued in WA
Practice address
5406 Leary Ave NW
Seattle, WA 98107-4068
Phone
(296) 784-0700
NPI assigned
May 26, 2022
Last updated
May 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X OD61318732 WA Primary

Addresses

Primary practice location

5406 Leary Ave NW
Seattle, WA 98107-4068

Mailing address

5406 Leary Ave NW
Seattle, WA 98107-4068

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
I20221210000248 WA Practitioner - Optometry 5193194306 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Plus of Ballard PS Optometrist CurrentSince May 14, 2023 Accepting new patients
Doris Wong OD PS Optometrist CurrentSince Aug 26, 2023 Accepting new patients
Vision Plus in Marysville, PS Optometrist CurrentSince Oct 28, 2022 Accepting new patients
Steven a. Davis. O.D., P.S. Optometrist Past Accepting new patients
Rstars, PLLC Optometrist PastSince Oct 28, 2022 Accepting new patients
Stanwood Eye Clinic, Inc PastSince Oct 28, 2022 Accepting new patients
Mill Creek Family Eyewear Optometrist Past Accepting new patients

Locations

9516 State Ave
Ste A
Marysville, WA 98270
Phone (360) 658-5071

321 Burnett Ave S
Ste 100
Renton, WA 98057
Phone (425) 277-0500

5406 Leary Ave NW
Seattle, WA 98107
Phone (206) 784-0700

Organizations & group practices 7

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": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1639817729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5406 LEARY AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 LEARY AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074068",
            "telephone_number": "296-784-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYOSO",
        "first_name": "PHOEBE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61318732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.