Individual provider Active NPI

Donald A Travis, OD

  • Optometrist
  • Kennewick, WA
National Provider Identifier
1881694941
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0000003112 Issued in WA
Practice address
7301 W Deschutes Ave Ste B
Kennewick, WA 99336-7799
Phone
(509) 735-2020
Fax
(509) 735-2020
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0000003112 WA Primary

Addresses

Primary practice location

7301 W Deschutes Ave Ste B
Kennewick, WA 99336-7799

Mailing address

7301 W Deschutes Ave Ste B
Kennewick, WA 99336-7799
Phone (509) 735-2020

Other identifiers 2

IdentifierTypeStateIssuer
0196714OtherWALOBOR AND INDUSTRIES
2019172MedicaidWA

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
I20050131000416 WA Practitioner - Optometry 2961452644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7301 W Deschutes Ave
Suite B
Kennewick, WA 99336-7799
Phone (509) 735-2020

Merit-based Incentive Payment System (MIPS)

Final score
12.5 of 100Reported as individual
Quality
25
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000003112WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Crest Eye Care Inc PS Optometrist CurrentSince Aug 1, 2008 Accepting new patients
Cantley Vision Inc PS Optometrist PastSince Jul 31, 2015 Accepting new patients
Eyecare Vision and Optical Optometrist PastSince Jul 7, 2008 Accepting new patients

Locations

7301 W Deschutes Ave
Ste B
Kennewick, WA 99336
Phone (509) 735-2020

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1881694941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 W DESCHUTES AVE STE B",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367799",
            "telephone_number": "509-735-2020",
            "fax_number": "509-735-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 W DESCHUTES AVE STE B",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367799",
            "telephone_number": "509-735-2020",
            "fax_number": "509-735-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "DONALD",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "0000003112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOBOR AND INDUSTRIES",
            "identifier": "0196714",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019172",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.