Ken Kenji Mayemura, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TX3084 Issued in WA

Practice address

3202 W McGraw St
Seattle, WA 98199-3208

Phone

(206) 284-5850

Fax

(206) 600-5850

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Southern California College of Optometry, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Washington Professional PCGroup PAC ID 3476927997, 61 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Washington Professional PC

  • Optometrist
  • Bellevue, WA
  • NPI 1134835176
  Medicare reassignment Care Compare group NPD
• Mayemura, Inc.

  • Optometrist
  • Everett, WA
  • NPI 1689857690
  Medicare reassignment NPD
• Mayemura, Inc.

  • Optometrist
  • Bothell, WA
  • NPI 1427299056
  NPD Authorized official
• Roy Bartlett DO PS

  • Ophthalmology Physician
  • Bothell, WA
  • NPI 1356551329

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1821131814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 W MCGRAW ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993208",
            "telephone_number": "206-284-5850",
            "fax_number": "206-600-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 W MCGRAW ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981993208",
            "telephone_number": "206-284-5850",
            "fax_number": "206-600-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYEMURA",
        "first_name": "KEN",
        "middle_name": "KENJI",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "TX3084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021095",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Maye, RN
• Sumaya Maye
• Kenneth Eugene Mayeda, M.D.
• Laura Mayeda, MD
• Mayemura Inc.
• Anne Nakhanu Mayende
• Claire Mayer-Jordan
• Amy Lynn Mayer
• Carol Roxanne Mayer, DVM
• Charles Jacob Mayer, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.