Active NPI
Diana Pan, O.D.
- Optometrist
- Tukwila, WA
National Provider Identifier
1972891810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD60383458
- Practice address
- 301 Southcenter Mall
Tukwila, WA 98188-2810 - Phone
- (206) 243-2322
- Fax
- (206) 209-0002
- NPI assigned
- Jul 13, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD60383458 | WA | Primary |
Addresses
Primary practice location
301 Southcenter Mall
Tukwila, WA 98188-2810
Mailing address
301 Southcenter Mall
Tukwila, WA 98188-2810
Phone (206) 243-2322
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2913 S 38TH St
Suite B3
Tacoma, WA 98409-5629
Phone (253) 473-1050
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barry Huse OD & Associates PS | Current | Accepting new patients | |
| Ballston Optometry, LLC | Optometrist | Past | Accepting new patients |
Locations
2913 S 38th St
Ste B3
Tacoma, WA 98409
Phone (253) 473-1050
Interoperability endpoints
- https://barryhuseod.ef.prod.fhir.ema-api.com/fhir/r4/
Organizations & group practices 2
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.
-
- Health Service Clinic/Center
- Tacoma, WA
- NPI 1760667695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402012800000",
"number": "1972891810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 SOUTHCENTER MALL",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981882810",
"telephone_number": "206-243-2322",
"fax_number": "206-209-0002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 SOUTHCENTER MALL",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981882810",
"telephone_number": "206-243-2322",
"fax_number": "206-209-0002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAN",
"first_name": "DIANA",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-13",
"last_updated": "2014-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD60383458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tukwila, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; 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.