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DR. WENSI SUN M.D., PH.D.
NPI 1104037043
Ophthalmology in Seattle, WA

Active since May 24, 2007PECOS EnrolledAccepts Medicare Assignment
11231 ROOSEVELT WAY, NE, SEATTLE, WA 98125(206) 365-5800(206) 364-2072 Get Directions Write a Review

NPPES record last updated: September 24, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Wensi Sun M.d., Ph.d. NPPES

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

DR. WENSI SUN M.D., PH.D. (NPI 1104037043) is an individual ophthalmology provider in Seattle, Washington, licensed in Washington (MD00039922) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with University Of Washington Medical Ctr, and is a graduate of Other (1983).

NPPES Registry Identity

NPI1104037043
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. WENSI SUNCredential: M.D., PH.D.
Location Address11231 ROOSEVELT WAY, NESeattle, WA 98125
Mailing Address11231 Roosevelt Way NeSeattle, WA 98125-6225 · (206) 365-5800 · Fax (206) 364-2072
Phone(206) 365-5800
Fax(206) 364-2072
Sole ProprietorYes
Medical School CMSOtherGraduated 1983
Enumeration DateMay 24, 2007
Last NPPES UpdateSeptember 24, 2014
✔ NPI 1104037043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in WA · MD00039922
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
11231 ROOSEVELT WAY, NE, Seattle, WA 98125
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Other Identifiers 3

Medicare UPINH38393
Medicare PING8852976WA
Medicaid8277964WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming, PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Wensi Sun M.d., Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698742427
PECOS Enrollment IDI20040915000043
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Exam of the internal drainage system of eye 92020
This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.
162 services126 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
135 services115 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
110 services63 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
70 services69 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
34 services27 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
30 services30 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Washington Medical Ctr

Acute Care Hospitals · Seattle, WA
3/5 CMS rating
OwnershipGovernment - State
CMS Certification Number500008
Location1959 NE Pacific St Box 356151Seattle, WA 98195 · King County
Emergency services Birthing friendly

Overlake Hospital Medical Center

Acute Care Hospitals · Bellevue, WA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number500051
Location1035-116th Ave NEBellevue, WA 98004 · King County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98125 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$143.76 typical visit price
range $63.67 – $189.37
Typical copayment $35.94 (range $15.91 – $47.34)
Most-billed visit code 99204
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…
100%20 patients5/55-star benchmark: 100%
Age-Related Macular Degeneration (AMD): Dilated Macular Examination
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…
100%43 patients5/55-star benchmark: 100%
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
100%34 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Wensi Sun's NPI number?

The NPI number for Wensi Sun is 1104037043. It was assigned to this individual provider in the NPPES registry on May 24, 2007.

Where is Wensi Sun located?

Wensi Sun practices at 11231 Roosevelt Way, NE, Seattle, WA 98125. The listed phone number is (206) 365-5800.

What is Wensi Sun's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Wensi Sun enrolled in Medicare?

Yes. Wensi Sun is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Wensi Sun accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Wensi Sun as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Wensi Sun affiliated with any hospitals?

According to CMS data, Wensi Sun is affiliated with University Of Washington Medical Ctr and Overlake Hospital Medical Center.

When was this NPI record last updated?

The NPPES record for Wensi Sun was last updated on September 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.