Individual provider Active NPI

Kate Nicole Stubbs, OD

  • Optometrist
  • Astoria, OR
National Provider Identifier
1912749557
Registry record updated Jun 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ATI4735 Issued in OR
Practice address
553 18TH St
Astoria, OR 97103-3505
Phone
(503) 325-4401
NPI assigned
Jun 12, 2024
Last updated
Jun 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD61572978 WA
Optometrist 152W00000X ATI4735 OR Primary

Addresses

Primary practice location

553 18TH St
Astoria, OR 97103-3505

Mailing address

553 18TH St
Astoria, OR 97103-3505

Other practice location 1

819 S Holladay Dr
Seaside, OR 97138-6608
Phone (503) 738-5361

Other practice location 2

1703 Pacific Ave S
Long Beach, WA 98631-3400
Phone (360) 642-3214

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240712002541 WA Practitioner - Optometry 3971048059 Reassigns benefits to 1 organization
I20240716002538 OR Practitioner - Optometry 3971048059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Darren L Thorsen, ODGroup PAC ID 9739161902, shared by 2 NPIs, 3 clinicians

Practice addresses (Care Compare)

1703 Pacific Ave S
Long Beach, WA 98631-3400
Phone (360) 642-3214

553 18TH St
Astoria, OR 97103-3505
Phone (503) 325-4401

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ATI4735ORMDOptometrist
OD61572978WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Darren L Thorsen OD Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Darren L Thorsen, OD Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Coastal Eye Care LLC Optometrist Past Accepting new patients

Locations

553 18th St
Astoria, OR 97103
Phone (503) 325-3661

819 S Holladay Dr
Seaside, OR 97138
Phone (503) 610-1025

1703 Pacific Ave S
Long Beach, WA 98631
Phone (360) 642-3214

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719705600000",
    "number": "1912749557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 18TH ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 18TH ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033505",
            "telephone_number": "503-325-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "819 S Holladay Dr",
            "address_purpose": "LOCATION",
            "city": "Seaside",
            "state": "OR",
            "postal_code": "971386608",
            "country_code": "US",
            "telephone_number": "503-738-5361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1703 Pacific Ave S",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "WA",
            "postal_code": "986313400",
            "country_code": "US",
            "telephone_number": "360-642-3214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUBBS",
        "first_name": "KATE",
        "middle_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-30",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61572978",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, OR

Sources for this page

Verify at the official NPI Registry.