PUYALLUP VISION SOURCE PS
NPI 1174294870
Optometrist in Puyallup, WA
About Puyallup Vision Source Ps NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PUYALLUP VISION SOURCE PS (NPI 1174294870) is a healthcare organization registered as an optometrist in Puyallup, Washington and active in the NPI registry since September 2021. The organization maintains a secondary practice location in University Place and lists Michael David Noble, Doctor/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)
Puyallup Vision Source Ps is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Puyallup Vision Source Ps, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
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 Pearl Eyecare Center P S's NPI number?
The NPI number for Pearl Eyecare Center P S is 1174294870. It was assigned to this organization in the NPPES registry on September 22, 2021. The provider is doing business as Puyallup Vision Source Ps and Puyallup Vision Source.
Where is Pearl Eyecare Center P S located?
Pearl Eyecare Center P S is located at 113 W Pioneer, Puyallup, WA 98371. The listed phone number is (253) 845-8215.
What is Pearl Eyecare Center P S's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Pearl Eyecare Center P S enrolled in Medicare?
Yes. Pearl Eyecare Center P S is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Pearl Eyecare Center P S?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Optometry, reassign their Medicare billing to Pearl Eyecare Center P S. 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, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Pearl Eyecare Center P S accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Pearl Eyecare Center P S 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 Pearl Eyecare Center P S was last updated on October 9, 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.
# Puyallup Vision Source Ps · NPI 1174294870
Optometrist organization in Puyallup, Washington. Organization record, active in the CMS NPPES registry since September 22, 2021.
## Identity
- **NPI:** 1174294870 (Entity type: Organization)
- **Enumerated:** September 22, 2021
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Legal business name:** Pearl Eyecare Center P S
- **Also known as:** Puyallup Vision Source (Doing Business As)
- **Organization subpart:** Yes (part of Pearl Eyecare Center P S)
- **Authorized official:** Michael Noble, DOCTOR/OWNER
## Practice location
- **Address:** 113 W PIONEER, Puyallup, WA 98371-5373
- **Phone:** (253) 845-8215 · **Fax:** (253) 845-7030
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 9, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1174294870) · Data from the CMS NPPES public registry.