Craig Rouse

Primary specialty

OptometristTaxonomy code 152W00000X

License

MR0424806 Issued in WA

Practice address

8160 Freedom LN NE
Suite D
Lacey, WA 98516-4753

Phone

(360) 455-4425

Fax

(360) 455-3200

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 8

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Washington Professional PCGroup PAC ID 3476927997, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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 Care Compare group NPD
• Nico Rouse Corporation P S

  • Optometrist
  • McChord Afb, WA
  • NPI 1215103288
  NPD Authorized official
• Nico Rouse Corporation PC

  • Optometrist
  • Elmendorf Afb, AK
  • NPI 1023182821
  NPD (past) Authorized official
• Texas Exchange Eye Care, L.P.

  • Optometrist
  • Fort Worth, TX
  • NPI 1679516330
  NPD (past) Authorized official
• Tricia Phan OD LLC

  • Optometrist
  • Tacoma, WA
  • NPI 1255611034
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1720021330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9321 MILBURN LOOP SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985133420",
            "telephone_number": "360-790-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8160 FREEDOM LN NE",
            "address_2": "SUITE D",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985164753",
            "telephone_number": "360-455-4425",
            "fax_number": "360-455-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "CRAIG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003743",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "226",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "MR0424806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PIN #",
            "identifier": "202160317",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD PIN",
            "identifier": "4536RO",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PIN #",
            "identifier": "721551995",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN #",
            "identifier": "410048942",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO PROVIDER #",
            "identifier": "7283193",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD2260",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER GROUP # DE9528",
            "identifier": "P00327511",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO PROVIDER #",
            "identifier": "3183314",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Rose, CCC-SLP
• Ross Jagger Sapp PLLC
• Sydney Rebecca Rothfels, LMP
• Sarah Rothwell
• Brian Kent Rounds, DDS
• Joel Cameron Rouse, MA 60713373
• Jessica Rowlett
• Royal Life Centers, LLC
• Royal Life Centers, LLC
• Royal Wa Lacey LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.