DR. JACLYN T PHAN O.D.
NPI 1114078235
Optometrist - Corneal and Contact Management in Bothell, WA
About Dr. Jaclyn T Phan O.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JACLYN T PHAN O.D. (NPI 1114078235) is an individual corneal and contact management provider in Bothell, Washington, licensed in Washington (3357) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jaclyn T Phan O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Jaclyn Phan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Everett, WA 98208
- Reassigned Medicare billing, Washington enrollment
- 25 clinicians in this Medicare group
Mercer Island, WA 98040
- Reassigned Medicare billing, Washington enrollment
- 4 clinicians in this Medicare group
Kent, WA 98031
- Reassigned Medicare billing, Washington enrollment
- 5 clinicians in this Medicare group
Tacoma, WA 98409
- Reassigned Medicare billing, Washington enrollment
- 2 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98012 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jaclyn Phan's NPI number?
The NPI number for Jaclyn Phan is 1114078235. It was assigned to this individual provider in the NPPES registry on January 16, 2007.
Where is Jaclyn Phan located?
Jaclyn Phan practices at 1912 201st Pl SE Suite 204, Bothell, WA 98012. The listed phone number is (425) 485-6812.
What is Jaclyn Phan's specialty?
The primary specialty registered for this NPI is Optometrist, specializing in Corneal and Contact Management, with taxonomy code 152WC0802X.
Is Jaclyn Phan enrolled in Medicare?
Yes. Jaclyn Phan is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Jaclyn Phan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jaclyn Phan reassigns Medicare benefits to 4 organizations: Blue Wave Eye Doctors Professional Limited Liability Company (Everett, WA), Sea Family Eye Care, PLLC (Mercer Island, WA), Clear Sight Northwest, Ps (Kent, WA) and Tricia Phan Od LLC (Tacoma, WA). Each 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 Jaclyn Phan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jaclyn Phan accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 3 other insurers list Jaclyn Phan 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.
When was this NPI record last updated?
The NPPES record for Jaclyn Phan was last updated on November 23, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Dr. Jaclyn T Phan, O.D. · NPI 1114078235
Corneal and Contact Management provider in Bothell, Washington. Individual provider, active in the CMS NPPES registry since January 16, 2007.
## Identity
- **NPI:** 1114078235 (Entity type: Individual)
- **Enumerated:** January 16, 2007
- **Primary specialty:** Optometrist - Corneal and Contact Management · taxonomy 152WC0802X
- **State license:** 3357 (Washington)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1912 201ST PL SE, SUITE 204, Bothell, WA 98012-8570
- **Phone:** (425) 485-6812
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Blue Wave Eye Doctors Professional Limited Liability Company (NPI 1053060475, Everett, WA); Sea Family Eye Care, PLLC (NPI 1124459193, Mercer Island, WA); Clear Sight Northwest, Ps (NPI 1740558642, Kent, WA); Tricia Phan Od LLC (NPI 1255611034, Tacoma, WA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 23, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1114078235) · Data from the CMS NPPES public registry.