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EVERGREEN EYE SURGERY CENTER
NPI 1821167479
Clinic/Center - Ambulatory Surgical in Federal Way, WA

Active since November 07, 2006
34719 6TH AVE S, FEDERAL WAY, WA 98003(206) 212-2100(206) 212-2174 Get Directions Write a Review

NPPES record last updated: January 12, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 3, 2024, Dec 19, 2019 (2 updates tracked since 2019).

About Evergreen Eye Surgery Center NPPES

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

EVERGREEN EYE SURGERY CENTER (NPI 1821167479) is a healthcare organization registered as an ambulatory surgical in Federal Way, Washington and active in the NPI registry since November 2006. The organization lists Rosa Angelica Campos, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1821167479
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameEVERGREEN EYE CENTER, PLLC
Location Address34719 6TH AVE SFederal Way, WA 98003-8714
Mailing Address34719 6th Ave SFederal Way, WA 98003-8714 · (206) 212-2100 · Fax (206) 212-2171
Phone(206) 212-2100
Fax(206) 212-2174
Organization SubpartNo
Authorized OfficialRosa Angelica CamposCredentialing Manager · (206) 215-2004
Enumeration DateNovember 7, 2006
Last NPPES UpdateJanuary 12, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 12, 2024
✔ NPI 1821167479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
34719 6TH AVE S, Federal Way, WA 98003
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Other Names 1

Doing Business AsEvergreen Eye Surgery Center

Other Identifiers 6

Other490003159WA · Railroad Medicare Asc Num
Medicaid7081250WA
OtherEV5682WA · Regence Asc Number
OtherP06705WA · Pcmb Asc Number
Other111881WA · L&i Asc Number
OtherNBNWA · Wa0527

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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)

Evergreen Eye Surgery Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Evergreen Eye Surgery Center, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Bradley Frederickson, O.D.
Optometry
NPI 1174631899
34719 6TH AVE S
Federal Way, WA 98003
(206) 212-2100
✔ PECOS✔ Accepts MedicareSame address
Brice Nicholson, DO
Ophthalmology
NPI 1508837584
1 BOONE RD NAVAL HOSPITAL BREMERTON
Bremerton, WA 98312
(360) 475-4686
✔ PECOS✔ Accepts Medicare27 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
844 services505 patients
Removal of recurring cataract in lens capsule using a laser 66821
This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
435 services298 patients
Laser repair to improve eye fluid flow 65855
Laser repair to improve eye fluid flow is a procedure aimed at treating glaucoma. A laser is used to create a small hole in the eye's drainage system, allowing fluid to flow out more easily. This helps to lower the pressure inside the eye, reducing the risk of vision loss.
106 services64 patients
Complex removal of cataract with insertion of prosthetic lens 66982
This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.
80 services64 patients
Removal of excessive skin and fat of upper eyelid 15823
This procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.
50 services25 patients

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 Evergreen Eye Center, PLLC's NPI number?

The NPI number for Evergreen Eye Center, PLLC is 1821167479. It was assigned to this organization in the NPPES registry on November 7, 2006. The provider is doing business as Evergreen Eye Surgery Center.

Where is Evergreen Eye Center, PLLC located?

Evergreen Eye Center, PLLC is located at 34719 6th Ave S, Federal Way, WA 98003. The listed phone number is (206) 212-2100.

What is Evergreen Eye Center, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Is Evergreen Eye Center, PLLC enrolled in Medicare?

Yes. Evergreen Eye Center, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Evergreen Eye Center, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Evergreen Eye Center, PLLC, in Ophthalmology and Optometry. 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 Evergreen Eye Center, PLLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Evergreen Eye Center, PLLC 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 Evergreen Eye Center, PLLC was last updated on January 12, 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.