Bruce Lundin, OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

00003612 Issued in WA

Practice address

955 W Washington St
Sequim, WA 98382-3266

Phone

(360) 406-2034

NPI assigned

May 23, 2006

Last updated

Jun 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, ID2 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

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bruce Lundin OD LLC

  • Optometrist
  • North Logan, UT
  • NPI 1942746342

  ID, WA

  Medicare reassignment Authorized official
• Fred E Clayson MD PC

  • Ophthalmology Physician
  • Ogden, UT
  • NPI 1912001165
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Provo, UT
  • NPI 1891882155
  NPD (past)
• Standard Optical Company

  • Optometrist
  • West Point, UT
  • NPI 1659958841
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1750336152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W WASHINGTON ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823266",
            "telephone_number": "360-406-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W WASHINGTON ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823266",
            "telephone_number": "360-406-2034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "356 E 2440 N",
            "address_purpose": "LOCATION",
            "city": "North Logan",
            "state": "UT",
            "postal_code": "843411781",
            "country_code": "US",
            "telephone_number": "435-232-2690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 N Main St",
            "address_purpose": "LOCATION",
            "city": "North Logan",
            "state": "UT",
            "postal_code": "843411918",
            "country_code": "US",
            "telephone_number": "435-753-3906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2944 Mountain City Hwy",
            "address_purpose": "LOCATION",
            "city": "Elko",
            "state": "NV",
            "postal_code": "89801",
            "country_code": "US",
            "telephone_number": "435-232-2690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2944 Mountain City Hwy",
            "address_purpose": "LOCATION",
            "city": "Elko",
            "state": "NV",
            "postal_code": "89801",
            "country_code": "US",
            "telephone_number": "435-232-2690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDIN",
        "first_name": "BRUCE",
        "credential": "OD LLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "00003612",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NV",
            "license": "NV412",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "279166-9934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "726",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Lodge, D.C.
• Valerie B Lodge, FNP
• David Lopez, PT, DPT
• Loraine Lovejoy-Evans, MPT, DPT
• Corie Lowden
• Ann Louise Lyles, M.D.
• Deborah Lyles, CCC-SLP
• Harry Everett Lyndes, M.D.
• Jennifer Lynn
• Manuel Aguas Macapinlac Jr., M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.