BLUE WAVE EYE DOCTORS PROFESSIONAL LIMITED LIABILITY COMPANY
NPI 1053060475
Optometrist in Everett, WA
About Blue Wave Eye Doctors Professional Limited Liability Company NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLUE WAVE EYE DOCTORS PROFESSIONAL LIMITED LIABILITY COMPANY (NPI 1053060475) is a healthcare organization registered as an optometrist in Everett, Washington and active in the NPI registry since March 2022. The organization maintains 2 additional practice locations and lists Dolsie Mcdonald, Network Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Blue Wave Eye Doctors Professional Limited Liability Company is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
25Medicare enrollment records show 25 clinicians reassign Medicare billing to Blue Wave Eye Doctors Professional Limited Liability Company, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 4 within 10 miles. Listed here are the 20 practicing nearest to this location.
Nearest to this location (20)
See all 25Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Blue Wave Eye Doctors Professional Limited Liability Company's NPI number?
The NPI number for Blue Wave Eye Doctors Professional Limited Liability Company is 1053060475. It was assigned to this organization in the NPPES registry on March 22, 2022.
Where is Blue Wave Eye Doctors Professional Limited Liability Company located?
Blue Wave Eye Doctors Professional Limited Liability Company is located at 305 SE Everett Mall Way Ste 21, Everett, WA 98208. The listed phone number is (425) 386-8428.
What is Blue Wave Eye Doctors Professional Limited Liability Company's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Blue Wave Eye Doctors Professional Limited Liability Company enrolled in Medicare?
Yes. Blue Wave Eye Doctors Professional Limited Liability Company is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Blue Wave Eye Doctors Professional Limited Liability Company?
According to the CMS Revalidation Reassignment List (October 2026 release), 25 clinicians, all in Optometry, reassign their Medicare billing to Blue Wave Eye Doctors Professional Limited Liability Company. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Blue Wave Eye Doctors Professional Limited Liability Company was last updated on May 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Blue Wave Eye Doctors Professional Limited Liability Company · NPI 1053060475
Optometrist organization in Everett, Washington. Organization record, active in the CMS NPPES registry since March 22, 2022.
## Identity
- **NPI:** 1053060475 (Entity type: Organization)
- **Enumerated:** March 22, 2022
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Dolsie Mcdonald, NETWORK MANAGER
## Practice location
- **Address:** 305 SE EVERETT MALL WAY STE 21, Everett, WA 98208-3250
- **Phone:** (425) 386-8428 · **Fax:** (425) 267-0575
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 25 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address and 4 within 10 miles; [full list](https://npiprofile.com/npi/1053060475/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 14, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1053060475) · Data from the CMS NPPES public registry.