Michael Katsuto Matsunami, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1499 Issued in WA

Practice address

301A E Pike St
Seattle, WA 98122-3609

Phone

(206) 464-0472

Fax

(206) 464-0572

NPI assigned

Aug 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drmatsunami@broadway-vision-source.direct.kno2fy.com

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.

• Aeg Washington Professional PC

  • Optometrist
  • Bellevue, WA
  • NPI 1134835176
  Medicare reassignment NPD

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1699767962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301A E PIKE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981223609",
            "telephone_number": "206-464-0472",
            "fax_number": "206-464-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301A E PIKE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981223609",
            "telephone_number": "206-464-0472",
            "fax_number": "206-464-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUNAMI",
        "first_name": "MICHAEL",
        "middle_name": "KATSUTO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "061894",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017119",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE/BLUE SHIELD",
            "identifier": "MA0761",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alvin M. Matsumoto, M.D.
• Devon Matsumoto
• Kim M Matsumoto, MD
• Samantha Mari Matsunaka
• Claire Matsunami, MSW
• Stephanie Akemi Matsuura, MD
• Edward K Matsuwaka, RPH
• Sean Matsuwaka, MD
• Matt Brown-Ruegg DC PS
• Matt Meyers Therapy PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.