RICHARDSON EYE CLINIC
NPI 1396459616
Optometrist in Vancouver, WA

Q: What is Derry Family Eyecare LLC's NPI number?

The NPI number for Derry Family Eyecare LLC is 1396459616. It was assigned to this organization in the NPPES registry on January 11, 2023. The provider is doing business as Richardson Eye Clinic.

Q: What is Derry Family Eyecare LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since January 11, 2023

12116 SE MILL PLAIN BLVD, SUITE 1, VANCOUVER, WA 98684(360) 892-3828(360) 254-0576 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 18, 2023, Jan 11, 2023 (2 updates tracked since 2023).

On this page

About Richardson Eye Clinic NPPES

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

RICHARDSON EYE CLINIC (NPI 1396459616) is a healthcare organization registered as an optometrist in Vancouver, Washington and active in the NPI registry since January 2023. The organization lists Kristen Elaine Derry, Optometrist, as its authorized official.

NPPES Registry Identity

NPI1396459616

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameDERRY FAMILY EYECARE LLC

Location Address12116 SE MILL PLAIN BLVD, SUITE 1Vancouver, WA 98684

Mailing Address12116 Se Mill Plain Blvd, Suite 1Vancouver, WA 98684 · (360) 892-3828 · Fax (360) 254-0576

Phone(360) 892-3828

Fax(360) 254-0576

Organization SubpartNo

Authorized OfficialKristen Elaine DerryOptometrist · (360) 892-3828

Enumeration DateJanuary 11, 2023

Last NPPES UpdateNovember 27, 20232 updates tracked since enumeration

NPPES CertifiedNovember 27, 2023

✔ NPI 1396459616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

12116 SE MILL PLAIN BLVD, Vancouver, WA 98684

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Other Names 1

Doing Business AsRichardson Eye Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.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)

Richardson Eye Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Richardson Eye Clinic, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kristen Derry

Optometry

NPI 1730523788

12116 SE MILL PLAIN BLVD STE 1
Vancouver, WA 98684

(360) 719-1512

✔ PECOS✔ Accepts MedicareSame address

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 Derry Family Eyecare LLC's NPI number?

The NPI number for Derry Family Eyecare LLC is 1396459616. It was assigned to this organization in the NPPES registry on January 11, 2023. The provider is doing business as Richardson Eye Clinic.

Where is Derry Family Eyecare LLC located?

Derry Family Eyecare LLC is located at 12116 SE Mill Plain Blvd Suite 1, Vancouver, WA 98684. The listed phone number is (360) 892-3828.

What is Derry Family Eyecare LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Derry Family Eyecare LLC enrolled in Medicare?

Yes. Derry Family Eyecare LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Derry Family Eyecare LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Derry Family Eyecare LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Derry Family Eyecare LLC accept?

Health plans from BlueCross BlueShield of Tennessee list Derry Family Eyecare LLC 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 Derry Family Eyecare LLC was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.