Individual provider Active NPI

Marienne Alyssa Santa Elena, OD

  • Optometrist
  • Maple Valley, WA
National Provider Identifier
1851083281
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61449531 Issued in WA
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

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230718000667 WA Practitioner - Optometry 0749640175 Reassigns benefits to 1 organization

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
Santa Elena Hager Eye Care PLLCGroup PAC ID 6204319551, 2 clinicians

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 100Reported as group
Quality
78.76
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Elena Hager Eye Care PLLC Optometrist CurrentSince Feb 27, 2026 Accepting new patients
East Main Vision Clinic LLC Optometrist CurrentSince Jul 6, 2023 Accepting new patients
Maple Valley Vision Clinic PLLC Optometrist CurrentSince Feb 27, 2026 Accepting new patients
Good Samaritan Community Healthcare PastSince May 28, 2023 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.

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

Verify at the official NPI Registry.