Individual provider Active NPI

Brandon Watson, O.D.

  • Optometrist
  • Brewster, WA
National Provider Identifier
1770004392
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003328 Issued in CO
Practice address
123 Hospital Way
Brewster, WA 98812-0015
Phone
(509) 689-2342
Fax
(509) 689-9207
NPI assigned
Jul 5, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.0003328 CO Primary
Optometrist 152W00000X ODP-100420 ID
Optometrist 152W00000X OD60779306 WA

Addresses

Primary practice location

123 Hospital Way
Brewster, WA 98812-0015

Mailing address

PO Box 783
Hayden, ID 83835-0783
Phone (509) 689-2342

Other identifiers 1

IdentifierTypeStateIssuer
9000150236MedicaidCO

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
I20220323001585 WA Practitioner - Optometry 3870866577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DW Family Eye Care PLLCGroup PAC ID 8224423629, 2 clinicians

Practice addresses (Care Compare)

123 Hospital Way
Brewster, WA 98812-0015
Phone (509) 689-2342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.0003328COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DW Family Eye Care PLLC Optometrist CurrentSince Feb 25, 2022 Accepting new patients

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": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1770004392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838350783",
            "telephone_number": "509-689-2342",
            "fax_number": "509-689-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL WAY",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "988120015",
            "telephone_number": "509-689-2342",
            "fax_number": "509-689-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003328",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100420",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60779306",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000150236",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, WA

Sources for this page

Verify at the official NPI Registry.