MID COLUMBIA EYECARE CENTER, INC, PS
NPI 1750585972
Optometrist in Pasco, WA

Active since June 12, 2007CLIA 50D1101176 · Waiver
4403 W COURT ST STE J, PASCO, WA 99301(509) 547-9695(509) 547-5017 Get Directions Write a Review

NPPES record last updated: December 6, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mid Columbia Eyecare Center, Inc, Ps NPPES

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

MID COLUMBIA EYECARE CENTER, INC, PS (NPI 1750585972) is a healthcare organization registered as an optometrist in Pasco, Washington and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Romelia Sifuentez, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1750585972
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameMID COLUMBIA EYECARE CENTER, INC, PS
Location Address4403 W COURT ST STE JPasco, WA 99301-2879
Mailing Address4403 W Court St Ste JPasco, WA 99301-2879 · (509) 547-9695 · Fax (509) 547-5017
Fax(509) 547-5017
Organization SubpartNo
Authorized OfficialRomelia SifuentezOffice Manager · (509) 547-9695
Enumeration DateJune 12, 2007
Last NPPES UpdateDecember 6, 2023
NPPES CertifiedDecember 6, 2023
NPI 1750585972 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.

4403 W COURT ST STE J, Pasco, WA 99301

Other Identifiers 1

Medicaid2020683WA

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D1101176

Mid Columbia Eyecare Center Inc Ps · Pasco, WA
Active · expires Apr 4, 2028
CLIA Number50D1101176
Laboratory TypeMobile Laboratory
Certificate Effective DateJune 22, 2009
Certificate Expiration DateApril 4, 2028
Laboratory DirectorDaniel A. Perdue
Laboratory Phone(509) 547-9695
Laboratory LocationMid Columbia Eyecare Center Inc Ps4403 W Court Ste J, Pasco, WA 99301
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Mid-Columbia Eyecare Center Inc Ps carries, from the Medicare DMEPOS supplier directory.

Mid-Columbia Eyecare Center Inc Ps

DMEPOS supplier · Pasco, WA

Accepts Medicare assignment

Mid-Columbia Eyecare Center Inc Ps agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20658797
Medicare Participant SinceJanuary 1, 1998
Supplier Location4403 W Court St Ste JPasco, WA 99301
Supplier Specialties
Optometrist

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750585972, enumerated as an "organization" on June 12, 2007.

The provider is located at 4403 W COURT ST STE J PASCO, WA 99301 and the phone number is (509) 547-9695.

Optometrist with taxonomy code 152W00000X.

The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska, Medicare. Please consult your insurance carrier or call the provider to verify.