Individual provider Active NPI

Steven E Eriksen, O.D.

  • Optometrist
  • Redmond, WA
National Provider Identifier
1851488639
Registry record updated Aug 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD 0001073 Issued in WA
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, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2009

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2258309MedicaidWA
G000101484OtherWAMEDICARE 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

LicenseStateTypeSpecialty
OD 0001073WAMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Redmond Vision Clinic, PLLC Optometrist CurrentSince Jan 8, 2013 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": []
}

Other providers in Redmond, WA

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.

Verify at the official NPI Registry.