Individual provider Active NPI

Victoria Roan, OD

  • Optometrist
  • Bellevue, WA
National Provider Identifier
1699170258
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD 60474759 Issued in WA
Practice address
2606 116TH Ave NE Ste 100
Bellevue, WA 98004-1422
Phone
(425) 462-7664
Fax
(425) 462-6429
NPI assigned
Oct 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD 60474759 WA Primary

Addresses

Primary practice location

2606 116TH Ave NE Ste 100
Bellevue, WA 98004-1422

Mailing address

PO Box 1506
Chehalis, WA 98532-0409
Phone (360) 242-3008

Other identifiers 1

IdentifierTypeStateIssuer
2050775MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address victoria.roan.p1@direct.pcli.nextgenshare.com

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
I20151209000104 WA Practitioner - Optometry 7012218431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Cataract and Laser Institute Inc PCGroup PAC ID 7517864119, 75 clinicians

Practice addresses (Care Compare)

1402 Lake Tapps Pkwy SE
Suite F106
Auburn, WA 98092-8157
Phone (253) 929-1295

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD 60474759WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Cataract and Laser Institute, Inc., P.C. CurrentSince Nov 23, 2015 Accepting new patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Pacific Cataract and Laser Institute Inc PC CurrentSince Nov 23, 2015 Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. Current Accepting new patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. Past Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. Past Accepting new patients

Locations

1402 Lake Tapps Pkwy SE
Ste F106
Auburn, WA 98092
Phone (253) 288-8882

2606 116th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 462-7664

4330 Mitchell Way
Bellingham, WA 98226
Phone (360) 736-6860

2517 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 748-8632

6695 W Rio Grande Ave
Kennewick, WA 99336
Phone (509) 736-0826

115 New View Ct NE
Olympia, WA 98506
Phone (360) 252-1642

9598 Mickelberry Rd NW
Silverdale, WA 98383
Phone (360) 698-5062

16818 E Desmet Ct
Spokane Valley, WA 99216
Phone (360) 242-3008

2915 S Alder St
Tacoma, WA 98409
Phone (253) 473-0275

2205 NE 129th St
Vancouver, WA 98686
Phone (360) 450-6644

3900 Kern Rd
Yakima, WA 98902
Phone (509) 966-1356

Interoperability endpoints

  • Direct secure messaging: victoria.roan.p1@direct.pcli.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1699170258",
    "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": "2606 116TH AVE NE STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041422",
            "telephone_number": "425-462-7664",
            "fax_number": "425-462-6429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROAN",
        "first_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 60474759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2050775",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "victoria.roan.p1@direct.pcli.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2606 116th Ave NE Ste 100",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980041422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.