Kyleigh Johnson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD.61276001 Issued in WA

Practice address

1801 10TH Ave NW
Issaquah, WA 98027-5384

Phone

(425) 369-6726

NPI assigned

Jan 25, 2022

Last updated

Aug 3, 2024By the provider in NPPES

Sex

Female

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, OR2 enrollments

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 2

Specialty

Optometry

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eric Bergstrom OD, PLLCGroup PAC ID 0941190417, 11 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eric Bergstrom OD, PLLC

  dba Eye Clinics of Seattle - Roosevelt

  • Optometrist
  • Seattle, WA
  • NPI 1124289897
  Medicare reassignment Care Compare group
• Katherine a. Ruecker, O.D, & Associates, P.C.

  • Optometrist
  • Hillsboro, OR
  • NPI 1689025678
  Medicare reassignment NPD
• Lena Barghouti-Afranji & Associates Professional Corp

  • Optometrist
  • Vancouver, WA
  • NPI 1184752198
  NPD
• Bonney Lake Optical, Inc

  dba Spanaway Lake Optical

  • Optometrist
  • Bonney Lake, WA
  • NPI 1902953581
  NPD (past)

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1891447363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 SE 18TH ST",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "980458015",
            "telephone_number": "913-221-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 10TH AVE NW",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275384",
            "telephone_number": "425-369-6726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 NE Vancouver Mall Dr Ste 232",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986626418",
            "country_code": "US",
            "telephone_number": "360-882-9355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYLEIGH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD.61276001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penny Johansen
• Sophia John Vega
• Danielle Katherine Johnson
• Emily Claire Johnson
• Jennifer Johnson, MA, LMHCA
• Mallory Marie Johnson, LMP
• Mary-Elizabeth Johnson
• Melinda Brooke Johnson, MA, LMFT, PMH-C
• Paula B Johnson, MS, LMHC
• Tiffany Charlene Johnson, CNM, ARNP

• Optometrist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.