FAIRHAVEN VISION CLINIC PLLC
NPI 1356413439
Optometrist in Bellingham, WA
About Fairhaven Vision Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAIRHAVEN VISION CLINIC PLLC (NPI 1356413439) is a healthcare organization registered as an optometrist in Bellingham, Washington and active in the NPI registry since November 2006. The organization lists Nancy Irene Jacobsen, Optical Technician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
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)
Fairhaven Vision Clinic Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Fairhaven Vision Clinic PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 Fairhaven Vision Clinic PLLC's NPI number?
The NPI number for Fairhaven Vision Clinic PLLC is 1356413439. It was assigned to this organization in the NPPES registry on November 14, 2006.
Where is Fairhaven Vision Clinic PLLC located?
Fairhaven Vision Clinic PLLC is located at 1207 Old Fairhaven Pkwy, Bellingham, WA 98225. The listed phone number is (360) 733-1190.
What is Fairhaven Vision Clinic PLLC's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Fairhaven Vision Clinic PLLC enrolled in Medicare?
Yes. Fairhaven Vision Clinic PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Fairhaven Vision Clinic PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Fairhaven Vision Clinic 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, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Fairhaven Vision Clinic PLLC accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Fairhaven Vision Clinic 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 Fairhaven Vision Clinic PLLC was last updated on September 14, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Fairhaven Vision Clinic Pllc · NPI 1356413439
Optometrist organization in Bellingham, Washington. Organization record, active in the CMS NPPES registry since November 14, 2006.
## Identity
- **NPI:** 1356413439 (Entity type: Organization)
- **Enumerated:** November 14, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Nancy Jacobsen, OPTICAL TECHNICIAN
## Practice location
- **Address:** 1207 OLD FAIRHAVEN PKWY, Bellingham, WA 98225-7411
- **Phone:** (360) 733-1190 · **Fax:** (360) 734-1306
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 14, 2009
- **Other identifiers:** Medicare NSC 6254340001 (WA); Other 616790001 (WA); Medicare PIN G8803246 (WA)
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Source: [NPI Profile](https://npiprofile.com/npi/1356413439) · Data from the CMS NPPES public registry.