Organization Active NPI

Custom Ocular Prosthetics LLC

  • Prosthetic/Orthotic Supplier
  • Seattle, WA
National Provider Identifier
1770145138
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
CUSTOM OCULAR PROSTHETICS LLC
Practice address
10212 5TH Ave NE Ste 210
Seattle, WA 98125-7471
Phone
(206) 522-4222
Fax
(206) 525-1496
NPI assigned
Jul 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Authorized official

Name
Brian E KoceskiNPI 1144882556
Title
Office Manager
Phone
(206) 522-4222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

10212 5TH Ave NE Ste 210
Seattle, WA 98125-7471

Mailing address

10212 5TH Ave NE Ste 210
Seattle, WA 98125-7471
Phone (206) 522-4222

Other names 1

  • Custom Ocular Prosthetics Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251212000682 WA DME Supplier - Ocularist 9133613599 Practice locations: Seattle, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Custom Ocular Prosthetics LLC10212 5TH Ave NE, Seattle, WA 98125-7471(206) 522-4222 Ocular Prostheses Accepts assignmentParticipating since Jan 23, 2026

National Provider Directory

National Provider Directory

Locations

10212 5th Ave NE
Ste 210
Seattle, WA 98125
Phone (206) 522-4222

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781222400000",
    "number": "1770145138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10212 5TH AVE NE STE 210",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257471",
            "telephone_number": "206-522-4222",
            "fax_number": "206-525-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10212 5TH AVE NE STE 210",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257471",
            "telephone_number": "206-522-4222",
            "fax_number": "206-525-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM OCULAR PROSTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-05",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A",
        "authorized_official_last_name": "KOCESKI",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "206-522-4222"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Custom Ocular Prosthetics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.