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MOUNTLAKE TERRACE EYE CARE
NPI 1093098402
Optometrist in Mountlake Terrace, WA

Active since September 21, 2011
23009 56TH AVE W, STE. A, MOUNTLAKE TERRACE, WA 98043(425) 778-0133(425) 778-8833 Get Directions Write a Review

NPPES record last updated: September 21, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mountlake Terrace Eye Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOUNTLAKE TERRACE EYE CARE (NPI 1093098402) is a healthcare organization registered as an optometrist in Mountlake Terrace, Washington and active in the NPI registry since September 2011. The organization lists Ken Kenji Mayemura, Owner / Optometric Physician, as its authorized official.

NPPES Registry Identity

NPI1093098402
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameMAYEMURA, INC.
Location Address23009 56TH AVE W, STE. AMountlake Terrace, WA 98043-4713
Mailing Address14050 Juanita Dr Ne, Ste. AKirkland, WA 98034-9708 · (425) 820-2020 · Fax (425) 821-9576
Phone(425) 778-0133
Fax(425) 778-8833
Organization SubpartNo
Authorized OfficialKen Kenji MayemuraOwner / Optometric Physician · (425) 778-0133
Enumeration DateSeptember 21, 2011
✔ NPI 1093098402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
23009 56TH AVE W, Mountlake Terrace, WA 98043
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Other Names 1

Doing Business AsMountlake Terrace Eye Care

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mountlake Terrace Eye Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Mountlake Terrace Eye Care, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Gary Archer, O.D.
Optometry
NPI 1790864205
14050 JUANITA DR NE STE A
Kirkland, WA 98034
(425) 820-2020
✔ PECOS5.3 mi
Brenda Burden, O.D.
Optometry
NPI 1760526628
14050 JUANITA DR NE SUITE A
Kirkland, WA 98034
(425) 820-2020
✔ PECOS✔ Accepts Medicare5.3 mi
Katherine Shen, O.D.
Optometry
NPI 1922315282
14050 JUANITA DR NE STE A
Kirkland, WA 98034
(425) 820-2020
✔ PECOS✔ Accepts Medicare5.3 mi
Danielle Robertson, OD
Optometry
NPI 1689234304
9800 4TH AVE NE
Seattle, WA 98115
(206) 302-1200
✔ PECOS✔ Accepts Medicare6.2 mi
Amalia Poquiz, OD
Optometry
NPI 1689824955
11314 4TH AVE W SUITE 108
Everett, WA 98204
(425) 353-5544
✔ PECOS✔ Accepts Medicare8.0 mi
Ken Mayemura, O.D.
Optometry
NPI 1821131814
3202 W MCGRAW ST
Seattle, WA 98199
(206) 284-5850
✔ PECOS✔ Accepts Medicare11 mi
Dixita Patel, OD
Optometry
NPI 1053670737
1000 MINOR AVE APT 1106
Seattle, WA 98104
(765) 412-0336
✔ PECOS12 mi
Jeffrey Dabundo, OD
Optometry
NPI 1912564410
325 9TH AVE
Seattle, WA 98104
(206) 520-5000
✔ PECOS✔ Accepts Medicare13 mi

Source: 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 Mayemura, Inc.'s NPI number?

The NPI number for Mayemura, Inc. is 1093098402. It was assigned to this organization in the NPPES registry on September 21, 2011. The provider is doing business as Mountlake Terrace Eye Care.

Where is Mayemura, Inc. located?

Mayemura, Inc. is located at 23009 56th Ave W Ste. A, Mountlake Terrace, WA 98043. The listed phone number is (425) 778-0133.

What is Mayemura, Inc.'s specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Mayemura, Inc. enrolled in Medicare?

Yes. Mayemura, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mayemura, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians, all in Optometry, reassign their Medicare billing to Mayemura, Inc.. 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, 5 practice 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 Mayemura, Inc. was last updated on September 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.