DR. STACY MAYUMI TAKETA (O.D.) – Optometrist, NPI 1235265547

DR. STACY MAYUMI TAKETA (O.D.) is a healthcare provider. based in Seattle, Washington. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 003611 (WA). The NPI Number for DR. STACY MAYUMI TAKETA (O.D.) is 1235265547

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
DR. STACY MAYUMI TAKETA (O.D.)
NPI
1235265547
Phone
(206) 432-9051
Address
5101 25TH AVE NE STE 10
Enumeration Date
23 February 2007
Last Update Date
14 October 2011

Doctor Profile

Medical School Name
NEW ENGLAND COLLEGE OF OPTOMETRY
Secondary Phone
2064329051
Graduation Year
2000 (26 years ago)
PAC ID
3173690534
Group Practice PAC ID
9638295561
Professional Enrollment ID
I20080926000249
Address ID
WA981053225SE5101XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,098 OPTOMETRY in WA

Provider Addresses for DR. STACY MAYUMI TAKETA (O.D.)

  • 5101 25TH AVE NE STE 10

    SEATTLE, WA 981053225

    Phone: (206) 432-9051

    Fax: (206) 432-9264

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 34 Open Payments records for all available years, with a total value of $1,453.

Total Amount is formed as General ($1,453) + Research ($0) + Ownership ($0) = $1,453.

Last reported payment date: 2024-12-02 • Largest payer in this snapshot: CooperVision Inc. ($708).

Total Amount

$1,453

General + Research + Ownership

Payments

34

Total payment records

General Amount

$1,453

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-02

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-09-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080926000249IOptometryWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system1212$0
View full utilization report →

Insurance plans in this area (ZIP 98105)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638295561View full group profile
NameSpecialtyState
O P T O M E T R YVA
O P T O M E T R YWA

Reviews

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Frequently asked questions

What NPI should I save for DR. STACY MAYUMI TAKETA (O.D.)?
Save NPI 1235265547 if you need a stable reference for DR. STACY MAYUMI TAKETA (O.D.).
Does this profile mean DR. STACY MAYUMI TAKETA (O.D.) is currently active?
Yes — DR. STACY MAYUMI TAKETA (O.D.) appears active in the national provider directory.
What kind of provider is DR. STACY MAYUMI TAKETA (O.D.)?
The page reflects Optometrist for DR. STACY MAYUMI TAKETA (O.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. STACY MAYUMI TAKETA (O.D.)?
The page summarizes Seattle, Washington for DR. STACY MAYUMI TAKETA (O.D.); expand the address list for detail.
Is DR. STACY MAYUMI TAKETA (O.D.) a real provider?
This page reflects official NPPES data for NPI 1235265547. Always confirm identity and privileges with the practice and licensing boards.

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