Individual provider Active NPI

Stacy Lynn Tovarek, O.D.

  • Optometrist
  • Gig Harbor, WA
National Provider Identifier
1659360394
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
03945 Issued in WA
Practice address
3220 Uddenberg LN
Suite 5
Gig Harbor, WA 98335-5128
Phone
(253) 851-2020
NPI assigned
Oct 16, 2005
Last updated
Jan 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 03945 WA Primary
Optometrist 152W00000X 280T WY

Addresses

Primary practice location

3220 Uddenberg LN
Suite 5
Gig Harbor, WA 98335-5128

Mailing address

PO Box 2020
Gig Harbor, WA 98335-4020
Phone (253) 851-2020

Other identifiers 2

IdentifierTypeStateIssuer
P00375324OtherWARAILROAD MEDICARE PIN
2030989MedicaidWA

Other names 1

  • Dr. Stacy Lynn Paul Former name

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
I20050718000068 WA Practitioner - Optometry 3476548710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3220 Uddenberg LN
Suite 5
Gig Harbor, WA 98335-5128
Phone (253) 851-2020

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03945WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gig Harbor Vision Center PS Optometrist CurrentSince Nov 30, 2009 Accepting new patients
Contact Lens Associates, LLC PastSince Jan 29, 2007 Accepting new patients

Locations

3220 Uddenberg Ln
Ste 5
Gig Harbor, WA 98335
Phone (253) 851-2020

Organizations & group practices 2

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": "1129420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1659360394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2020",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983354020",
            "telephone_number": "253-851-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 UDDENBERG LN",
            "address_2": "SUITE 5",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983355128",
            "telephone_number": "253-851-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOVAREK",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-16",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "03945",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "280T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00375324",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030989",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "PAUL",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gig Harbor, WA

Sources for this page

Verify at the official NPI Registry.