NPIMap

Organization Active NPI

Kirkland Eye Clinic, P.S.

  • Optometrist
  • Woodinville, WA
National Provider Identifier
1972643526
Registry record updated Nov 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KIRKLAND EYE CLINIC, P.S.
Practice address
17924 140TH Ave NE Ste 200
Woodinville, WA 98072-4315
Phone
(425) 483-8000
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2022

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

Authorized official

Name
Kim EngNPI 1902946569
Title
President
Phone
(425) 483-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 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

Other practice location 1

18209 Bothell Way NE
Bothell, WA 98011-1921
Phone (425) 486-2121

Other names 2

  • Bothell Vision Center Doing business as
  • RedWood Eye Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051018001187 WA Part B Supplier - Clinic/Group Practice 0244256378 Receives reassigned benefits from 6 practitioners
Practice locations: Bothell, WA; Woodinville, WA

National Provider Directory

National Provider Directory

Locations

18209 Bothell Way NE
Bothell, WA 98011
Phone (425) 486-2121

17601 140th Ave NE
Ste 200
Woodinville, WA 98072
Phone (425) 483-8000

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or 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-2",
    "last_updated_epoch": "1669507200000",
    "number": "1972643526",
    "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": [
        {
            "address_1": "18209 Bothell Way NE",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980111921",
            "country_code": "US",
            "telephone_number": "425-486-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIRKLAND EYE CLINIC, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2022-11-27",
        "certification_date": "2022-11-27",
        "status": "A",
        "authorized_official_last_name": "ENG",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-483-8000"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bothell Vision Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RedWood Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodinville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.