Individual provider Active NPI

Kimberly M. Farea, OD

  • Optometrist
  • Seattle, WA
National Provider Identifier
1730135781
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003571 Issued in WA
Practice address
10416 5TH Ave NE
Seattle, WA 98125-7402
Phone
(206) 517-6700
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00003571 WA Primary

Addresses

Primary practice location

10416 5TH Ave NE
Seattle, WA 98125-7402

Mailing address

10416 5TH Ave NE
Seattle, WA 98125-7402
Phone (206) 517-6700

Other practice location 1

1101 Madison St Ste 301
Seattle, WA 98104-3599
Phone (206) 505-1101

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kfarea1042800@wm.providencedirect.org Direct
Direct Messaging Address kfarea1042800@wm.providencedirect.org Direct

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
I20050406001225 WA Practitioner - Optometry 9133176548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

1200 12TH Ave S
Seattle, WA 98144-2712
Phone (206) 326-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD00003571WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics CurrentSince Sep 12, 2006 Accepting new patients
Pacmed Clinics CurrentSince Sep 12, 2006 Accepting new patients
Pacmed Clinics Current Accepting new patients

Locations

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

10416 5th Ave NE
Seattle, WA 98125
Phone (206) 517-6667

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

Interoperability endpoints

  • Direct secure messaging: kfarea1042800@wm.providencedirect.org

Organizations & group practices 3

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1730135781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10416 5TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257402",
            "telephone_number": "206-517-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10416 5TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257402",
            "telephone_number": "206-517-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Madison St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981043599",
            "country_code": "US",
            "telephone_number": "206-505-1101",
            "fax_number": "206-505-1277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAREA",
        "first_name": "KIMBERLY",
        "middle_name": "M.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfarea1042800@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10416 5th Ave NE",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981257402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfarea1042800@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1101 Madison St Ste 301",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981043599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.