Individual provider Active NPI

Benyam Asfha Kahsai

  • Optometrist
  • Lynnwood, WA
National Provider Identifier
1740710193
Registry record updated Jun 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60759540 Issued in WA
Practice address
3000 184TH St SW Ste 206
Lynnwood, WA 98037-4769
Phone
(425) 775-6069
NPI assigned
Jun 18, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60759540 WA Primary

Addresses

Primary practice location

3000 184TH St SW Ste 206
Lynnwood, WA 98037-4769

Mailing address

18422 41St PL W
Lynnwood, WA 98037-3713
Phone (206) 962-1638

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
I20180213001180 WA Practitioner - Optometry 6103186192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Everett Optometry Clinic, PLLCGroup PAC ID 9638249782, 2 clinicians

Practice addresses (Care Compare)

3700 Colby Ave
Everett, WA 98201-4911
Phone (425) 252-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60759540WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Everett Optometry Clinic, PLLC Optometrist CurrentSince Jan 1, 2018 Accepting new patients

Locations

3700 Colby Ave
Everett, WA 98201
Phone (425) 252-2937

Interoperability endpoints

  • Direct secure messaging: drbenyamkahsai@everett-optometry-clinic.direct.kno2fy.com

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": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497744000000",
    "number": "1740710193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18422 41ST PL W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980373713",
            "telephone_number": "206-962-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 184TH ST SW STE 206",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374769",
            "telephone_number": "425-775-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHSAI",
        "first_name": "BENYAM",
        "middle_name": "ASFHA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60759540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.