Katy Tan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD.OD.61397190 Issued in WA

Practice address

10101 19TH Ave SE Ste B
Everett, WA 98208-4255

Phone

(425) 338-5400

NPI assigned

Jun 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI, WA2 enrollments

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 2

Specialty

Optometry

Education

Pacific University - College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Darran Kim OD PLLCGroup PAC ID 6507210572, 3 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.

• Darran Kim O.D. PLLC

  • Optometrist
  • Everett, WA
  • NPI 1033891304
  Medicare reassignment Care Compare group NPD
• DRS Lee & Leong OD LLC

  • Corneal and Contact Management Optometrist
  • Kahului, HI
  • NPI 1528287497
  Medicare reassignment NPD
• Maui Optix LLC

  • Optometrist
  • Makawao, HI
  • NPI 1336371327
  Medicare reassignment NPD

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1720648611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16550 NE 79TH ST APT 203",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522474",
            "telephone_number": "808-276-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 19TH AVE SE STE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084255",
            "telephone_number": "425-338-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "KATY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD.OD.61397190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Ann Tallman, M.D.
• Michael J Tamber, MD
• Nicholas Tamburri, PA-C
• Tsion Semeneh Tamrat
• Tan-Nelson LLC
• Stella C Tanedo, MD
• Sangchi Tang, DDS
• April Ann Tanis, LMP
• Patricia C Tannen, RN
• Leigh Tao, APRN FAMILY PRACTICE

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.