QUEEN ANNE EYE CLINIC
NPI 1124289897
Optometrist in Seattle, WA
About Queen Anne Eye Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
QUEEN ANNE EYE CLINIC (NPI 1124289897) is a healthcare organization registered as an optometrist in Seattle, Washington and active in the NPI registry since June 2008. The organization maintains a secondary practice location in Seattle and lists Eric John Bergstrom, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 2
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Queen Anne Eye Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
13Medicare enrollment records show 13 clinicians reassign Medicare billing to Queen Anne Eye Clinic, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 8 within 10 miles. They are listed nearest first.
Clinicians, nearest first (13)
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 Eric Bergstrom Od, PLLC's NPI number?
The NPI number for Eric Bergstrom Od, PLLC is 1124289897. It was assigned to this organization in the NPPES registry on June 24, 2008. The provider is doing business as Queen Anne Eye Clinic and Eye Clinics of Seattle - Roosevelt.
Where is Eric Bergstrom Od, PLLC located?
Eric Bergstrom Od, PLLC is located at 20 Boston St, Seattle, WA 98109. The listed phone number is (206) 282-8120.
What is Eric Bergstrom Od, PLLC's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Eric Bergstrom Od, PLLC enrolled in Medicare?
Yes. Eric Bergstrom Od, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Eric Bergstrom Od, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians, all in Optometry, reassign their Medicare billing to Eric Bergstrom Od, PLLC. 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, 3 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Eric Bergstrom Od, PLLC accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Eric Bergstrom Od, PLLC 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 Eric Bergstrom Od, PLLC was last updated on May 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Queen Anne Eye Clinic · NPI 1124289897
Optometrist organization in Seattle, Washington. Organization record, active in the CMS NPPES registry since June 24, 2008.
## Identity
- **NPI:** 1124289897 (Entity type: Organization)
- **Enumerated:** June 24, 2008
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Legal business name:** Eric Bergstrom Od, Pllc
- **Also known as:** Eye Clinics of Seattle - Roosevelt (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Eric Bergstrom, OWNER
## Practice location
- **Address:** 20 BOSTON ST, Seattle, WA 98109-2319
- **Phone:** (206) 282-8120 · **Fax:** (206) 282-8046
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 13 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 3 practice at this address and 8 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 8, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1124289897) · Data from the CMS NPPES public registry.