Individual provider Active NPI

Nicholas Jankowski, O.D.

  • Optometrist
  • Vancouver, WA
National Provider Identifier
1659766004
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60670018 Issued in WA
Practice address
1405 SE 164TH Ave Ste 102
Vancouver, WA 98683-9644
Phone
(360) 253-4405
Fax
(360) 823-0035
NPI assigned
Apr 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD60670018 WA Primary
Vision Therapy Optometrist 152WV0400X OD60670018 WA
Pediatric Optometrist 152WP0200X OD60670018 WA
Low Vision Rehabilitation Optometrist 152WL0500X OD60670018 WA

Addresses

Primary practice location

1405 SE 164TH Ave Ste 102
Vancouver, WA 98683-9644

Mailing address

1405 SE 164TH Ave Ste 102
Vancouver, WA 98683-9644
Phone (360) 253-4405

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
I20161207001958 WA Practitioner - Optometry 4880974906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Eye Care Center P CGroup PAC ID 6103957196, 3 clinicians

Practice addresses (Care Compare)

1405 SE 164TH Ave
Suite 102
Vancouver, WA 98683-9644
Phone (360) 253-4405

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Eye Care Center P C Optometrist CurrentSince Oct 23, 2016 Accepting new patients

Locations

14415 SE Mill Plain Blvd
Ste 115B
Vancouver, WA 98684
Phone (360) 253-4405

1405 SE 164th Ave
Ste 102
Vancouver, WA 98683
Phone (360) 253-4405

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1659766004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-253-4405",
            "fax_number": "360-823-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-253-4405",
            "fax_number": "360-823-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANKOWSKI",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60670018",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "WA",
            "license": "OD60670018",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "WA",
            "license": "OD60670018",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "WA",
            "license": "OD60670018",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.