LIBERTY LAKE EYECARE CENTER PS
NPI 1609889039
Optometrist in Liberty Lake, WA
About Liberty Lake Eyecare Center Ps NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LIBERTY LAKE EYECARE CENTER PS (NPI 1609889039) is a healthcare organization registered as an optometrist in Liberty Lake, Washington and active in the NPI registry since August 2006. The organization lists Bret Allen Ulrich, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Liberty Lake Eyecare Center Ps is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 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
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Liberty Lake Eyecare Center Ps, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Liberty Lake, WA 99019
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 Liberty Lake Eyecare Center Ps's NPI number?
The NPI number for Liberty Lake Eyecare Center Ps is 1609889039. It was assigned to this organization in the NPPES registry on August 15, 2006.
Where is Liberty Lake Eyecare Center Ps located?
Liberty Lake Eyecare Center Ps is located at 22011 E Country Vista Dr Ste 101, Liberty Lake, WA 99019. The listed phone number is (154) 178-6332.
What is Liberty Lake Eyecare Center Ps's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Liberty Lake Eyecare Center Ps enrolled in Medicare?
Yes. Liberty Lake Eyecare Center Ps is registered in the Medicare PECOS enrollment system.
When is Liberty Lake Eyecare Center Ps's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Washington, Physician - Optometrist) is due for revalidation by January 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 Liberty Lake Eyecare Center Ps?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Liberty Lake Eyecare Center Ps. 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 Liberty Lake Eyecare Center Ps 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 BlueCross BlueShield of Tennessee and 1 other insurer list Liberty Lake Eyecare Center Ps 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 Liberty Lake Eyecare Center Ps was last updated on September 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Liberty Lake Eyecare Center Ps · NPI 1609889039
Optometrist organization in Liberty Lake, Washington. Organization record, active in the CMS NPPES registry since August 15, 2006.
## Identity
- **NPI:** 1609889039 (Entity type: Organization)
- **Enumerated:** August 15, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Bret Ulrich, PRESIDENT
## Practice location
- **Address:** 22011 E COUNTRY VISTA DR STE 101, Liberty Lake, WA 99019-5242
- **Phone:** (154) 178-6332 · **Fax:** (509) 893-3703
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (DME, Washington, Physician - Optometrist) · CMS Revalidation Due Date List, October 2026 release
- **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 17, 2021
- **Other identifiers:** Medicaid 2023067 (WA)
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Source: [NPI Profile](https://npiprofile.com/npi/1609889039) · Data from the CMS NPPES public registry.