Individual provider Active NPI

Karen L Preston, O.D.

  • Pediatric Optometrist
  • Bellevue, WA
National Provider Identifier
1861436438
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
OD00001609 Issued in WA
Practice address
14645 Bel Red Rd
Ste E102
Bellevue, WA 98007-3929
Phone
(425) 732-6056
Fax
(425) 732-6059
NPI assigned
Jun 15, 2006
Last updated
Feb 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X OD00001609 WA Primary

Addresses

Primary practice location

14645 Bel Red Rd
Ste E102
Bellevue, WA 98007-3929

Mailing address

14645 Bel Red Rd
Suite E102
Bellevue, WA 98007-3929
Phone (425) 732-6056

Other identifiers 1

IdentifierTypeStateIssuer
2024370MedicaidWA

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
I20051004000563 WA Practitioner - Optometry 8820023336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14715 NE Bel Red Rd
Suite 202
Bellevue, WA 98007-3956
Phone (425) 732-6056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD00001609WAMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Pediatric Eye Care P.S. Pediatrics CurrentSince Aug 1, 2005 Accepting new patients
Eye Care Specialists Northwest PLLC Past Accepting new patients

Locations

14645 NE Bel Red Rd
Ste E102
Bellevue, WA 98007
Phone (425) 732-6056

14715 NE Bel Red Rd
Ste 202
Bellevue, WA 98007
Phone (425) 732-6056

Organizations & group practices 2

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1861436438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14645 BEL RED RD",
            "address_2": "SUITE E102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073929",
            "telephone_number": "425-732-6056",
            "fax_number": "425-732-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14645 BEL RED RD",
            "address_2": "STE E102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073929",
            "telephone_number": "425-732-6056",
            "fax_number": "425-732-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "KAREN",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "WA",
            "license": "OD00001609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024370",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.