Kim P Eckroth, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00003986 Issued in WA

Practice address

8204 27TH St W
University Place, WA 98466-2719

Phone

(253) 564-9262

Fax

(253) 564-0996

NPI assigned

Feb 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

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

Pacific University - College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Care Associates PLLCGroup PAC ID 9739181728, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Vision Care Associates PLLC

  • Optometrist
  • University Place, WA
  • NPI 1033294103
  Medicare reassignment Care Compare group NPD
• Vision Care Associates PLLC

  • Optometrist
  • Yelm, WA
  • NPI 1417032590
  NPD

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1992777189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8204 27TH ST W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984662719",
            "telephone_number": "253-564-9262",
            "fax_number": "253-564-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8204 27TH ST W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984662719",
            "telephone_number": "253-564-9262",
            "fax_number": "253-564-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKROTH",
        "first_name": "KIM",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003986",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "OD00003986",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "WA",
            "license": "OD00003986",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "WA",
            "license": "OD00003986",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "WA",
            "license": "OD00003986",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000784",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah R Duncan, PAC
• Gary Joseph Dupuy Jr., DPT
• Jennifer Nicole Duszynski, RPH
• Erin Dwyer, LMFT
• Jacob D Dye
• Edward L Coyle PH.D. PLLC
• Dustin Edwards
• Thadra Clairpatra Edwards
• Zelia Ann Nalani Elam, BSW
• Elevation Home Care Inc

• Optometrist in University Place, WA
• Providers in University Place, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.