MILL CREEK VISION
NPI 1194094490
Optometrist in Mill Creek, WA
About Mill Creek Vision NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MILL CREEK VISION (NPI 1194094490) is a healthcare organization registered as an optometrist in Mill Creek, Washington and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Fred Masato Arima, Pres, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mill Creek Vision is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Mill Creek Vision, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
Mill Creek, WA 98012
Mill Creek, WA 98012
Mill Creek, WA 98012
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 50D2069335
Mill Creek Vision · Mill Creek, WAFrequently 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 Mill Creek Eye And Contact Lens Clinic, Inc.'s NPI number?
The NPI number for Mill Creek Eye And Contact Lens Clinic, Inc. is 1194094490. It was assigned to this organization in the NPPES registry on December 15, 2011. The provider is doing business as Mill Creek Vision.
Where is Mill Creek Eye And Contact Lens Clinic, Inc. located?
Mill Creek Eye And Contact Lens Clinic, Inc. is located at 15808 Mill Creek Blvd Suite #110, Mill Creek, WA 98012. The listed phone number is (425) 745-5650.
What is Mill Creek Eye And Contact Lens Clinic, Inc.'s specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Mill Creek Eye And Contact Lens Clinic, Inc. enrolled in Medicare?
Yes. Mill Creek Eye And Contact Lens Clinic, Inc. is registered in the Medicare PECOS enrollment system.
When is Mill Creek Eye And Contact Lens Clinic, Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Washington, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Mill Creek Eye And Contact Lens Clinic, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians, all in Optometry, reassign their Medicare billing to Mill Creek Eye And Contact Lens Clinic, 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, 3 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Mill Creek Eye And Contact Lens Clinic, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 50D2069335) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Mill Creek Eye And Contact Lens Clinic, Inc. accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Premera Blue Cross Blue Shield of Alaska list Mill Creek Eye And Contact Lens Clinic, Inc. 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 Mill Creek Eye And Contact Lens Clinic, Inc. was last updated on June 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Mill Creek Vision · NPI 1194094490
Optometrist organization in Mill Creek, Washington. Organization record, active in the CMS NPPES registry since December 15, 2011.
## Identity
- **NPI:** 1194094490 (Entity type: Organization)
- **Enumerated:** December 15, 2011
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Legal business name:** Mill Creek Eye And Contact Lens Clinic, Inc.
- **Organization subpart:** No
- **Authorized official:** Fred Arima, PRES
## Practice location
- **Address:** 15808 MILL CREEK BLVD, SUITE #110, Mill Creek, WA 98012-1500
- **Phone:** (425) 745-5650 · **Fax:** (425) 337-1342
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Washington, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 8 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 3 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 20, 2018
- **Other identifiers:** Medicaid 2011344 (WA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1194094490) · Data from the CMS NPPES public registry.