Individual provider Active NPI

Jennifer Diane Andrews, OD

  • Optometrist
  • Seattle, WA
National Provider Identifier
1720107469
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD3132 Issued in WA
Practice address
509 Olive Way
Suite 634
Seattle, WA 98101-1720
Phone
(206) 344-2020
Fax
(206) 623-5461
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD3132 WA Primary

Addresses

Primary practice location

509 Olive Way
Suite 634
Seattle, WA 98101-1720

Mailing address

3024 23Rd Ave W
Seattle, WA 98199-2923
Phone (206) 235-0789

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
I20220418000888 WA Practitioner - Optometry 4981091188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1994
Medicare assignment
May accept Medicare assignment
Group practices
Puget Sound Eye CareGroup PAC ID 2466341284, 6 clinicians

Practice addresses (Care Compare)

2501 N 45 St
Seattle, WA 98103-6909
Phone (206) 526-5222

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD3132WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Puget Sound Eye Care Optometrist CurrentSince Mar 14, 2022 Accepting new patients

Locations

12402 SE 38th St
Ste 203
Bellevue, WA 98006
Phone (425) 454-0200

2501 N 45th St
Seattle, WA 98103
Phone (206) 526-5060

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1720107469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 23RD AVE W",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981992923",
            "telephone_number": "206-235-0789",
            "fax_number": "206-623-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY",
            "address_2": "SUITE 634",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011720",
            "telephone_number": "206-344-2020",
            "fax_number": "206-623-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "JENNIFER",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD3132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.