Individual provider Active NPI

Keegan Kenneth Bench, O.D.

  • Optometrist
  • Spokane, WA
National Provider Identifier
1801204144
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60482624 Issued in WA
Practice address
510 S Colwey
Spokane, WA 99202
Phone
(509) 838-2531
Fax
(509) 755-6580
NPI assigned
Jul 30, 2014
Last updated
Sep 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60482624 WA Primary

Addresses

Primary practice location

510 S Colwey
Spokane, WA 99202

Mailing address

PO Box 3649
Spokane, WA 99220-3649

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
I20150922002800 WA Practitioner - Optometry 2264749340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

300 E 5TH Ave
Spokane, WA 99202-1334

311 S L St
Tacoma, WA 98405-3720

400 E 5TH Ave
Spokane, WA 99202-1334
Phone (509) 838-2531

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60482624WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Multicare Health System Current Accepting new patients
Rockwood Clinic PS Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

842 S Cowley St
Spokane, WA 99202
Phone (509) 624-5300

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: kbench330721@direct.multicare.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1801204144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3649",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S COLWEY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99202",
            "telephone_number": "509-838-2531",
            "fax_number": "509-755-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENCH",
        "first_name": "KEEGAN",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-30",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60482624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.