Mitchell D Brockett, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3652 Issued in WA

Practice address

2914 Mitchell Rd SE
Port Orchard, WA 98366-4428

Phone

(360) 874-2020

Fax

(360) 874-0567

NPI assigned

Dec 6, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2001

Medicare assignment

May accept Medicare assignment

Group practices

Kingston Eyecare Center, LLCGroup PAC ID 8426039629, 2 clinicians

Port Orchard Eyecare Centers Inc, PSGroup PAC ID 4385620202, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kingston Eyecare Center, LLC

  • Optometrist
  • Kingston, WA
  • NPI 1134293228
  Medicare reassignment Care Compare group NPD Authorized official
• Port Orchard Eyecare Centers Inc, PS

  • Optometrist
  • Port Orchard, WA
  • NPI 1326111501
  Medicare reassignment Care Compare group NPD Authorized official
• 20/20 Eyecare Centers Inc PS

  • Optometrist
  • Vashon, WA
  • NPI 1134292915
  NPD (past)
• Auburn Eyecare Center, LLC

  • Optometrist
  • Auburn, WA
  • NPI 1720152895
  NPD (past)
• Silverdale Eyecare Center Inc

  • Optometrist
  • Silverdale, WA
  • NPI 1588738165
  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1871577593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 MITCHELL RD SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664428",
            "telephone_number": "360-874-2020",
            "fax_number": "360-874-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 MITCHELL RD SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664428",
            "telephone_number": "360-874-2020",
            "fax_number": "360-874-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKETT",
        "first_name": "MITCHELL",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Brewer
• Jennifer Joanne Breyer, MSN, ARNP, FNP-C
• Carolyn Mae Brezler, LMP
• Carol Mae Brigham, SUDP
• Erin Rene' Broadway, MS CCC SLP
• Elizabeth Ann Brodie-Knope, PT
• Shane Op Brooks, DO
• McKinzey Lane Bross
• Amber Brown, LMP
• Anthony Jon Brown

• Optometrist in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.