NPIMap

Organization Active NPI

Casey J. Andrus, O.D., PLLC

Doing business as Stanwood Vision & Optical

  • Optometrist
  • Stanwood, WA
National Provider Identifier
1801126719
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4046 Issued in WA
Legal business name
CASEY J. ANDRUS, O.D., PLLC
Doing business as
Stanwood Vision & Optical
Practice address
9730 Sr 532 Ste D
Stanwood, WA 98292-8054
Phone
(360) 629-2066
NPI assigned
Dec 28, 2009
Last updated
Dec 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Authorized official

Name
Dr. Casey J. Andrus, O.D.NPI 1073586012
Title
Owner
Phone
(360) 657-2670

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4046 WA Primary

Addresses

Primary practice location

9730 Sr 532 Ste D
Stanwood, WA 98292-8054

Mailing address

6101 71St Dr NE
Marysville, WA 98270-8951

Other names 1

  • Stanwood Vision & Optical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100611000042 WA Part B Supplier - Clinic/Group Practice 3779613187 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Mount Vernon, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261958400000",
    "number": "1801126719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 71ST DR NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982708951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 SR 532 STE D",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982928054",
            "telephone_number": "360-629-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASEY J. ANDRUS, O.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-28",
        "last_updated": "2009-12-28",
        "status": "A",
        "authorized_official_last_name": "ANDRUS",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-657-2670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "4046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanwood Vision & Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stanwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.