SHAUNA MAZZULLA (O.D.) – Optometrist, NPI 1396893608
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,098 OPTOMETRY in WA
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Provider Addresses for SHAUNA MAZZULLA (O.D.)
602 228TH AVE NE
SAMMAMISH, WA 980747241
Phone: (425) 836-5352
Fax: (425) 898-9880
Type: Mailing
The Platform Leasing Office, 420, West Smith Street, Downtown, Kent, King County, Washington, 98032-1762, United States
SUITE 105
KENT, WA 980324423
Phone: (253) 867-1616
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $2,102.
Total Amount is formed as General ($2,102) + Research ($0) + Ownership ($0) = $2,102.
Last reported payment date: 2024-05-01 • Largest payer in this snapshot: Alcon Vision LLC ($1,608).
Total Amount
$2,102
General + Research + Ownership
Payments
8
Total payment records
General Amount
$2,102
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alcon Vision LLC | $1,608 |
| Johnson & Johnson Vision Care, Inc. | $277 |
| Bausch & Lomb Americas Inc. | $123 |
| BIOTISSUE HOLDINGS, INC. | $95 |
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: 2017-10-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171024001600 | I | Optometry | WA | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98074)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | HI | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | OR | |
| O P T O M E T R Y | UT | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | WA | |
| O P T O M E T R Y | IN |
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