Individual provider Active NPI

Rachael S Henrie, O.D.

  • Optometrist
  • Seattle, WA
National Provider Identifier
1982794657
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3887TX Issued in WA
Practice address
7001 Roosevelt Way NE
Seattle, WA 98115-5649
Phone
(206) 527-2987
Fax
(206) 527-1208
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3887TX WA Primary

Addresses

Primary practice location

7001 Roosevelt Way NE
Seattle, WA 98115-5649

Mailing address

7001 Roosevelt Way NE
Seattle, WA 98115-5649
Phone (206) 527-2987

Other identifiers 1

IdentifierTypeStateIssuer
2030864MedicaidWA

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
I20050826000883 WA Practitioner - Optometry 4880625060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roosevelt Vision Source PLLCGroup PAC ID 6709775521, 7 clinicians

Practice addresses (Care Compare)

9706 4TH Ave NE
Suite 100
Seattle, WA 98115-2199
Phone (206) 527-2987

Merit-based Incentive Payment System (MIPS)

Final score
77.33 of 100Reported as group
Quality
54.65
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3887TXWAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Roosevelt Vision Clinic, PLLC Optometrist CurrentSince Jul 24, 2012 Accepting new patients

Locations

9706 4th Ave NE
Ste 100
Seattle, WA 98115
Phone (206) 527-2987

Interoperability endpoints

  • Direct secure messaging: rachael.henrie@direct.revolutionehr.com

Organizations & group practices 1

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1982794657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 ROOSEVELT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981155649",
            "telephone_number": "206-527-2987",
            "fax_number": "206-527-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 ROOSEVELT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981155649",
            "telephone_number": "206-527-2987",
            "fax_number": "206-527-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIE",
        "first_name": "RACHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3887TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030864",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.