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DR. JERRY QUON TOM O.D.
NPI 1386753929
Optometrist - Corneal and Contact Management in Seattle, WA

Active since August 29, 2006Opted out of Medicare · through Jun 7, 2028
4323 UNIVERSITY WAY NE, SEATTLE, WA 98105(206) 633-1081(206) 633-1432 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jerry Quon Tom O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JERRY QUON TOM O.D. (NPI 1386753929) is an individual corneal and contact management provider in Seattle, Washington, licensed in Washington (WA 1895) and active in the NPI registry since August 2006. He has opted out of Medicare through June 7, 2028.

NPPES Registry Identity

NPI1386753929
Entity TypeIndividualMale
Primary Taxonomy152WC0802X
Provider Legal NameDR. JERRY QUON TOMCredential: O.D.
Location Address4323 UNIVERSITY WAY NESeattle, WA 98105-5808
Mailing Address4323 University Way NeSeattle, WA 98105-5808 · (206) 633-1081 · Fax (206) 633-1432
Phone(206) 633-1081
Fax(206) 633-1432
Sole ProprietorYes
Enumeration DateAugust 29, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1386753929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometrist · Corneal and Contact ManagementEye and Vision Services Providers
Taxonomy Code152WC0802X
License✔ Licensed in WA · WA 1895
Definition
The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear.
4323 UNIVERSITY WAY NE, Seattle, WA 98105
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jerry Quon Tom O.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 7, 2024 through June 7, 2028.

Opt-Out Effective DateJune 7, 2024
Opt-Out In Effect ThroughJune 7, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVIS OPTICAL XPRESS
Eyewear Supplier
4323 UNIVERSITY WAY NE
SEATTLE, WA 98105
King County (206) 633-5225

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 Jerry Tom's NPI number?

The NPI number for Jerry Tom is 1386753929. It was assigned to this individual provider in the NPPES registry on August 29, 2006.

Where is Jerry Tom located?

Jerry Tom practices at 4323 University Way NE, Seattle, WA 98105. The listed phone number is (206) 633-1081.

What is Jerry Tom's specialty?

The primary specialty registered for this NPI is Optometrist, specializing in Corneal and Contact Management, with taxonomy code 152WC0802X.

Is Jerry Tom enrolled in Medicare?

No. Jerry Tom has opted out of Medicare through June 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jerry Tom was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.