Individual provider Active NPI

Keren H. Yang, O.D.

  • Optometrist
  • Silverdale, WA
National Provider Identifier
1912965906
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003898 Issued in WA
Practice address
2200 NW Myhre Road
Silverdale, WA 98383-7681
Phone
(360) 830-1304
Fax
(360) 830-1380
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 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 OD00003898 WA Primary

Addresses

Primary practice location

2200 NW Myhre Road
Silverdale, WA 98383-7681

Mailing address

9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502

Other identifiers 1

IdentifierTypeStateIssuer
2034361MedicaidWA

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
I20080414000676 WA Practitioner - Optometry 6406868355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

2200 NW Myhre Rd
Silverdale, WA 98383-7681
Phone (360) 830-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD00003898WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Sep 3, 2016 Accepting new patients
Franciscan Medical Group CurrentSince Sep 3, 2016 Accepting new patients
Khy Optometry & Associates, PLLC PastSince Nov 16, 2009 Accepting new patients
Franciscan Medical Group Past Accepting new patients
Northern Valley Eyecare, Inc. Optometrist Past Accepting new patients

Locations

2200 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 830-1100

9621 Ridgetop Blvd NW
Silverdale, WA 98383
Phone (360) 782-3300

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: keren.yang@tdc.directbygreenway.com

Organizations & group practices 9

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1912965906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NW MYHRE ROAD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837681",
            "telephone_number": "360-830-1304",
            "fax_number": "360-830-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "KEREN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2034361",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.