Kandi Sue Moller, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60958770 Issued in WA

Practice address

4735 Point Fosdick Dr Ste 300
Gig Harbor, WA 98335-2314

Phone

(253) 432-4303

NPI assigned

Oct 11, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• The Eye Team, PC

  • Optometrist
  • Albany, OR
  • NPI 1659797025

  WA

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594425600000",
    "number": "1912096967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14014 82ND AVE NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983298855",
            "telephone_number": "541-979-1106",
            "fax_number": "253-514-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 POINT FOSDICK DR STE 300",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983352314",
            "telephone_number": "253-432-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLER",
        "first_name": "KANDI",
        "middle_name": "SUE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-07-11",
        "certification_date": "2020-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2733ATI",
            "primary": false
        },
        {
            "code": "193400000X",
            "taxonomy_group": "",
            "desc": "Single Specialty",
            "state": "OR",
            "license": "2733ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60958770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas W Mitchell, D.D.S., P.S.
• Laura Mizumoto, DPT
• Gail A Moe, RPH
• Cesar L Molina Sisimit, LMFTA
• Orestes Molina, MD
• Margi Elizabeth Montgomery, LMP
• Zachary Tyler Mooney, DC
• Jesse Kincaid Moore
• Matthew Moore, D.C.
• Wayne Walter Moore, D.C.

• Optometrist in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2020; 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.