Individual provider Active NPI

Kathryn A Wong-Groden, OD

  • Optometrist
  • Puyallup, WA
National Provider Identifier
1891369534
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61182206 Issued in WA
Practice address
1703 S Meridian Ste 101
Puyallup, WA 98371-7590
Phone
(253) 848-3000
NPI assigned
May 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD61182206 WA Primary

Addresses

Primary practice location

1703 S Meridian Ste 101
Puyallup, WA 98371-7590

Mailing address

1703 S Meridian Ste 101
Puyallup, WA 98371-7590

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
I20220711001306 WA Practitioner - Optometry 0749660595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cascade Eye and Skin Centers PCGroup PAC ID 4486541554, 47 clinicians

Practice addresses (Care Compare)

1703 S Meridian
Suite 101
Puyallup, WA 98371-7590
Phone (253) 848-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD61182206WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Eye & Skin Centers P.C. Current Accepting new patients
Cascade Eye & Skin Centers PC CurrentSince Aug 15, 2022 Accepting new patients

Locations

205 10th St NE
Ste 119
Auburn, WA 98002
Phone (253) 939-7911

10004 204th Ave E
Ste 1500
Bonney Lake, WA 98391

4907 Point Fosdick Dr
Ste E700
Gig Harbor, WA 98335

1703 S Meridian
Ste 101
Puyallup, WA 98371
Phone (253) 770-7708

5225 Cirque Dr W
Ste 200
University Place, WA 98467
Phone (253) 564-3365

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1891369534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-848-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG-GRODEN",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61182206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.