Individual provider Active NPI

Pei Wen Hua, OD

  • Optometrist
  • Seattle, WA
National Provider Identifier
1740913375
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
61319176 Issued in WA
Practice address
340 NE Northgate Way
Seattle, WA 98125
Phone
(206) 210-5963
NPI assigned
Jul 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 61319176 WA Primary

Addresses

Primary practice location

340 NE Northgate Way
Seattle, WA 98125

Mailing address

2926 103Rd PL SE
Everett, WA 98208-4530
Phone (510) 676-9809

Other practice location 1

2926 103rd Pl SE
Everett, WA 98208-4530
Phone (510) 676-9809

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
I20230131002617 WA Practitioner - Optometry 0749651651 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seattle Optometric Physicians PLLCGroup PAC ID 6901044049, 3 clinicians
North Seattle Vision Care PLLCGroup PAC ID 7315135357, 3 clinicians

Practice addresses (Care Compare)

14154 NE Woodinville Duvall Rd
Woodinville, WA 98072-8551
Phone (425) 485-2600

1912 201St PL SE
Suite 204
Bothell, WA 98012-8570
Phone (425) 485-6812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61319176WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Seattle Vision Care PLLC Optometrist CurrentSince Aug 26, 2024 Accepting new patients
Blue Wave Eye Doctors Professional Limited Liability Company CurrentSince Feb 6, 2023 Accepting new patients
Seattle Optometric Physicians PLLC Optometrist CurrentSince Aug 8, 2024 Accepting new patients
Blue Wave Eye Doctors Professional Limited Liability Company Optometrist CurrentSince Feb 6, 2023 Accepting new patients
Dr. Jaclyn Phan & Associates PastSince Aug 26, 2024 Accepting new patients

Locations

1912 201st Pl SE
Ste 204
Bothell, WA 98012
Phone (425) 485-6812

305 SE Everett Mall Way
Ste 21
Everett, WA 98208
Phone (425) 267-0575

340 NE Northgate Way
Seattle, WA 98125
Phone (206) 210-5963

14154 NE Woodinville Duvall Rd
Woodinville, WA 98072
Phone (425) 485-2600

Organizations & group practices 5

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1740913375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2926 103RD PL SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084530",
            "telephone_number": "510-676-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NE NORTHGATE WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98125",
            "telephone_number": "206-210-5963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2926 103rd Pl SE",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982084530",
            "country_code": "US",
            "telephone_number": "510-676-9809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUA",
        "first_name": "PEI",
        "middle_name": "WEN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "61319176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.