Individual provider Active NPI

Kim Eng

  • Optometrist
  • Woodinville, WA
National Provider Identifier
1902946569
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD3251 Issued in WA
Practice address
17924 140TH Ave NE Ste 200
Woodinville, WA 98072-4315
Phone
(425) 483-8000
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD3251 WA Primary

Addresses

Primary practice location

17924 140TH Ave NE Ste 200
Woodinville, WA 98072-4315

Mailing address

17924 140TH Ave NE Ste 200
Woodinville, WA 98072-4315

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
I20051019000100 WA Practitioner - Optometry 8224054366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kirkland Eye Clinic PSGroup PAC ID 0244256378, 4 clinicians

Practice addresses (Care Compare)

17924 140TH Ave NE
Suite 200
Woodinville, WA 98072-4315
Phone (425) 483-8000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD3251WAMDOptometrist

Organizations & group practices 1

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1902946569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17924 140TH AVE NE STE 200",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980724315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17924 140TH AVE NE STE 200",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980724315",
            "telephone_number": "425-483-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENG",
        "first_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD3251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodinville, WA

Sources for this page

Verify at the official NPI Registry.