NPIMap

Organization Active NPI

Northwest Eye Clinic Inc., P.S.

  • Eyewear Supplier
  • Bellingham, WA
National Provider Identifier
1992880553
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
NORTHWEST EYE CLINIC INC., P.S.
Practice address
3015 Squalicum Pkwy
Suite 270
Bellingham, WA 98225-1945
Phone
(360) 733-4800
Fax
(360) 733-2879
NPI assigned
Oct 25, 2006
Organization subpart
Yes
Parent organization
NORTHWEST EYE CLINIC INC PSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Authorized official

Name
Dr. Vincent Eriberto Matteucci, MDNPI 1366532897
Title
Physician
Phone
(360) 733-4800

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
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

3015 Squalicum Pkwy
Suite 270
Bellingham, WA 98225-1945

Mailing address

3015 Squalicum Pkwy
Suite 260
Bellingham, WA 98225-1945
Phone (360) 733-4800

Other identifiers 1

IdentifierTypeStateIssuer
2019032MedicaidWA

Other names 1

  • Northwest Eye Clinic Optical Shop Doing business as

National Provider Directory

National Provider Directory
Part of
Northwest Eye Clinic in

Locations

3015 Squalicum Pkwy
Ste 270
Bellingham, WA 98225
Phone (360) 733-4800

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 11

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298505600000",
    "number": "1992880553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 SQUALICUM PKWY",
            "address_2": "SUITE 260",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251945",
            "telephone_number": "360-733-4800",
            "fax_number": "360-733-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 SQUALICUM PKWY",
            "address_2": "SUITE 270",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251945",
            "telephone_number": "360-733-4800",
            "fax_number": "360-733-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST EYE CLINIC INC., P.S.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST EYE CLINIC INC PS",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-02-24",
        "status": "A",
        "authorized_official_last_name": "MATTEUCCI",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "ERIBERTO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "360-733-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019032",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Eye Clinic Optical Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.