NPIMap

Organization Active NPI

Kosnoski Eye Care Inc

Doing business as Kent Vision Clinic

  • Clinic/Center
  • Kent, WA
National Provider Identifier
1881774974
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
KOSNOSKI EYE CARE INC
Doing business as
Kent Vision Clinic
Practice address
10002 SE 240TH St
Kent, WA 98031-4839
Phone
(253) 852-2020
Fax
(253) 854-2020
NPI assigned
Oct 16, 2006
Last updated
May 28, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
KOSNOSKI EYE CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Edward M Kosnoski, ODNPI 1942200415
Title
Owner
Phone
(253) 852-2020

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
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

10002 SE 240TH St
Kent, WA 98031-4839

Mailing address

10002 SE 240TH St
Kent, WA 98031-4839
Phone (253) 852-2020

Other identifiers 2

IdentifierTypeStateIssuer
1021416MedicaidWA
DF8532OtherWARAILROAD MEDICARE

Other names 1

  • Kent Vision Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930044826 WA DME Supplier - Physician - Optometrist 7618978859 Practice locations: Kent, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Kosnoski Eye Care Inc4 organizations share this tax ID, including this one
Part of
Kosnoski Eye Care Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1748390400000",
    "number": "1881774974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10002 SE 240TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980314839",
            "telephone_number": "253-852-2020",
            "fax_number": "253-854-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10002 SE 240TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980314839",
            "telephone_number": "253-852-2020",
            "fax_number": "253-854-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOSNOSKI EYE CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOSNOSKI EYE CARE INC",
        "enumeration_date": "2006-10-16",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "KOSNOSKI",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-852-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021416",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF8532",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kent Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.