VALLEY VISION SOURCE PS
NPI 1710719034
Optometrist in Renton, WA
About Valley Vision Source Ps NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VALLEY VISION SOURCE PS (NPI 1710719034) is a healthcare organization registered as an optometrist in Renton, Washington and active in the NPI registry since August 2024. The organization lists Tiffany Hollenbeck, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Valley Vision Source Ps 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 Valley Vision Source Ps, which bills Medicare for the services they deliver. Of these, 2 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 Valley Vision Source Ps's NPI number?
The NPI number for Valley Vision Source Ps is 1710719034. It was assigned to this organization in the NPPES registry on August 15, 2024.
Where is Valley Vision Source Ps located?
Valley Vision Source Ps is located at 17800 Talbot Rd S Ste 200, Renton, WA 98055. The listed phone number is (425) 545-1010.
What is Valley Vision Source Ps's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Valley Vision Source Ps enrolled in Medicare?
Yes. Valley Vision Source Ps is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Valley Vision Source Ps?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Valley Vision Source 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, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Valley Vision Source 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 Valley Vision Source 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 Valley Vision Source Ps was last updated on September 10, 2024. 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.
# Valley Vision Source Ps · NPI 1710719034
Optometrist organization in Renton, Washington. Organization record, active in the CMS NPPES registry since August 15, 2024.
## Identity
- **NPI:** 1710719034 (Entity type: Organization)
- **Enumerated:** August 15, 2024
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Tiffany Hollenbeck, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 17800 TALBOT RD S STE 200, Renton, WA 98055-5740
- **Phone:** (425) 545-1010
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 10, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1710719034) · Data from the CMS NPPES public registry.