NPIMap

Organization Active NPI

Northwest Eye Clinic Inc., PS

  • Medical Specialty Clinic/Center
  • Bellingham, WA
National Provider Identifier
1861572034
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
NORTHWEST EYE CLINIC INC., PS
Practice address
3015 Squalicum Parkway
Suite 260
Bellingham, WA 98225-1945
Phone
(360) 733-4800
Fax
(360) 733-2879
NPI assigned
Oct 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Authorized official

Name
Vincent E. Matteucci, M.D.NPI 1366532897
Title
Treasurer
Phone
(360) 733-4800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

3015 Squalicum Parkway
Suite 260
Bellingham, WA 98225-1945

Mailing address

3015 Squalicum Parkway
Suite 260
Bellingham, WA 98225-1945
Phone (360) 733-4800

Other names 1

  • Northwest Eye Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217001150 WA Part B Supplier - Clinic/Group Practice 3971498031 Receives reassigned benefits from 8 practitioners
Practice locations: Bellingham, WA

National Provider Directory

National Provider Directory

Locations

3015 Squalicum Pkwy
Ste 260
Bellingham, WA 98225
Phone (360) 733-4800

Interoperability endpoints

  • Direct secure messaging: rparanthan@nwec.intellechartdirect.net
  • Direct secure messaging: iperszyk@nwec.intellechartdirect.net

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1861572034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 SQUALICUM PARKWAY",
            "address_2": "SUITE 260",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251945",
            "telephone_number": "360-733-4800",
            "fax_number": "360-733-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 SQUALICUM PARKWAY",
            "address_2": "SUITE 260",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251945",
            "telephone_number": "360-733-4800",
            "fax_number": "360-733-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST EYE CLINIC INC., PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "MATTEUCCI",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "360-733-4800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Eye Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.