Active NPI
Marienne Alyssa Santa Elena, OD
- Optometrist
- Maple Valley, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD61449531
- Practice address
- 23714 222ND PL SE Ste B
Maple Valley, WA 98038-5800 - Phone
- (425) 432-1206
- Fax
- (425) 413-4465
- NPI assigned
- May 24, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD61449531 | WA | Primary |
Addresses
Primary practice location
23714 222ND PL SE Ste B
Maple Valley, WA 98038-5800
Mailing address
23714 222ND PL SE Ste B
Maple Valley, WA 98038-5800
Phone (425) 432-1206
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
23714 222ND PL SE
Suite B
Maple Valley, WA 98038-5800
Phone (425) 432-1206
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.38 of 100
- Quality
- 78.76
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santa Elena Hager Eye Care PLLC | Optometrist | Current | Accepting new patients |
| East Main Vision Clinic LLC | Optometrist | Current | Accepting new patients |
| Maple Valley Vision Clinic PLLC | Optometrist | Current | Accepting new patients |
| Good Samaritan Community Healthcare | Past | Accepting new patients |
Locations
23714 222nd Pl SE
Ste B
Maple Valley, WA 98038
Phone (425) 432-1206
2732 E Main
#200
Puyallup, WA 98372
Phone (253) 770-2732
2732 E Main
Puyallup, WA 98372
Phone (253) 770-2732
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 and National Provider Directory roles.
-
- Optometrist
- Maple Valley, WA
- NPI 1659230068
-
- Optometrist
- Puyallup, WA
- NPI 1518160316
-
- Optometrist
- Maple Valley, WA
- NPI 1558475558
-
- Pain Medicine (Anesthesiology) Physician
- Puyallup, WA
- NPI 1437102399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784505600000",
"number": "1851083281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23714 222ND PL SE STE B",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980385800",
"telephone_number": "425-432-1206",
"fax_number": "425-413-4465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23714 222ND PL SE STE B",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980385800",
"telephone_number": "425-432-1206",
"fax_number": "425-413-4465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTA ELENA",
"first_name": "MARIENNE",
"middle_name": "ALYSSA",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-24",
"last_updated": "2026-07-20",
"certification_date": "2026-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD61449531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maple Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.