Kimberly Pandiangan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD.OD.60861434 Issued in WA

Practice address

6923 Coal Creek Pkwy SE
Newcastle, WA 98059-3136

Phone

(425) 641-2500

NPI assigned

May 31, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Pang Former name

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

Specialty

Optometry

Education

Southern California College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coal Creek Family Vision, PLLCGroup PAC ID 3173520285, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Coal Creek Family Vision, PLLC

  • Optometrist
  • Newcastle, WA
  • NPI 1629189915
  Medicare reassignment Care Compare group NPD
• Issaquah Eyeworks, LLC

  • Optometrist
  • Issaquah, WA
  • NPI 1699984310
  Medicare reassignment NPD

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1992297493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6923 COAL CREEK PKWY SE",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980593136",
            "telephone_number": "425-641-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6923 COAL CREEK PKWY SE",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980593136",
            "telephone_number": "425-641-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1145 NW Gilman Blvd Ste G12",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980278932",
            "country_code": "US",
            "telephone_number": "425-391-9331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3219 74th Pl SE",
            "address_purpose": "LOCATION",
            "city": "Mercer Island",
            "state": "WA",
            "postal_code": "980403463",
            "country_code": "US",
            "telephone_number": "206-300-4437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANDIANGAN",
        "first_name": "KIMBERLY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD.OD.60861434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "PANG",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Newcastle Dental Specialists LLC
• Jordan O'Neal
• Scott Mikio Oda, O.D.
• Gloria Odom
• Jack Ogilvie, DPT
• Payal Patel
• Patrick Wang DDS MD PLLC
• Andrea Pincus, MS, CF-SLP
• Trisha Lee Pollara, MD
• Public Hospital District #1 of King County

• Optometrist in Newcastle, WA
• Providers in Newcastle, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.

Verify at the official NPI Registry.