Active NPI
Steven E Eriksen, O.D.
- Optometrist
- Redmond, WA
National Provider Identifier
1851488639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD 0001073
- Practice address
- 16528 Cleveland St
Suite I
Redmond, WA 98052-4460 - Phone
- (425) 885-1974
- Fax
- (425) 882-7818
- NPI assigned
- Oct 5, 2006
- Last updated
- Aug 14, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD 0001073 | WA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | OD 0001073 | WA | |
| Pediatric Optometrist | 152WP0200X | OD 0001073 | WA | |
| Sports Vision Optometrist | 152WS0006X | OD 0001073 | WA | |
| Occupational Vision Optometrist | 152WX0102X | OD 0001073 | WA |
Addresses
Primary practice location
16528 Cleveland St
Suite I
Redmond, WA 98052-4460
Mailing address
16528 Cleveland St
Suite I
Redmond, WA 98052-4460
Phone (425) 885-1974
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2258309 | Medicaid | WA | |
| G000101484 | Other | WA | MEDICARE LEGACY PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OD 0001073 | WA | MD | Pediatric Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Redmond Vision Clinic, PLLC | Optometrist | Current | Accepting new patients |
Locations
17634 NE Union Hill Rd
Unit 120
Redmond, WA 98052
Phone (425) 885-1974
Organizations & group practices 1
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": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250208000000",
"number": "1851488639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16528 CLEVELAND ST",
"address_2": "SUITE I",
"city": "REDMOND",
"state": "WA",
"postal_code": "980524460",
"telephone_number": "425-885-1974",
"fax_number": "425-882-7818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16528 CLEVELAND ST",
"address_2": "SUITE I",
"city": "REDMOND",
"state": "WA",
"postal_code": "980524460",
"telephone_number": "425-885-1974",
"fax_number": "425-882-7818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERIKSEN",
"first_name": "STEVEN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2009-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD 0001073",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "WA",
"license": "OD 0001073",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "WA",
"license": "OD 0001073",
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "",
"desc": "Optometrist, Sports Vision",
"state": "WA",
"license": "OD 0001073",
"primary": false
},
{
"code": "152WX0102X",
"taxonomy_group": "",
"desc": "Optometrist, Occupational Vision",
"state": "WA",
"license": "OD 0001073",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2258309",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE LEGACY PROVIDER NUMBER",
"identifier": "G000101484",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.