DR. RODERICK BLAIR BEAZER (O.D.) – Optometrist, NPI 1790040673

DR. RODERICK BLAIR BEAZER (O.D.) is a healthcare provider. based in Lake stevens, Washington. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. OD60530417 (WA). The NPI Number for DR. RODERICK BLAIR BEAZER (O.D.) is 1790040673

Main info

Male
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
DR. RODERICK BLAIR BEAZER (O.D.)
NPI
1790040673
Phone
(717) 242-1915
Address
9623 32ND ST SE
Enumeration Date
7 July 2012
Last Update Date
28 October 2020

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
3606596255
Graduation Year
2012 (14 years ago)
PAC ID
2668621699
Group Practice PAC ID
3476927997
Professional Enrollment ID
I20160125002522
Address ID
WA982704318MA1098XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

1,098 OPTOMETRY in WA

Provider Addresses for DR. RODERICK BLAIR BEAZER (O.D.)

  • 9623 32ND ST SE

    STE D121

    LAKE STEVENS, WA 982585780

    Phone: (717) 242-1915

    Type: Mailing

  • 9623 32ND ST SE STE D121

    LAKE STEVENS, WA 982585780

    Phone: (425) 377-9747

    Fax: (425) 377-8757

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 10 Open Payments records for all available years, with a total value of $226.

Total Amount is formed as General ($226) + Research ($0) + Ownership ($0) = $226.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($153).

Total Amount

$226

General + Research + Ownership

Payments

10

Total payment records

General Amount

$226

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2016-01-25

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
I20160125002522IOptometryWATBD

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 system2222$0
92250Photography of the retina1515$0
View full utilization report →

Insurance plans in this area (ZIP 98258)

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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: 3476927997View full group profile
NameSpecialtyState
O P T O M E T R YHI
O P T O M E T R YWA
O P T O M E T R YWA
O P T O M E T R YWA
O P T O M E T R YOR
O P T O M E T R YUT
O P T O M E T R YWA
O P T O M E T R YWA
O P T O M E T R YWA
O P T O M E T R YWA

Reviews

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Frequently asked questions

Can I cross-check DR. RODERICK BLAIR BEAZER (O.D.) using NPI 1790040673?
NPI 1790040673 belongs to DR. RODERICK BLAIR BEAZER (O.D.); compare other details if you need extra assurance.
Would DR. RODERICK BLAIR BEAZER (O.D.) appear as active to a payer?
You can treat DR. RODERICK BLAIR BEAZER (O.D.) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. RODERICK BLAIR BEAZER (O.D.)?
DR. RODERICK BLAIR BEAZER (O.D.)'s record emphasizes Optometrist. Clinical services aligned with this taxonomy classification.
Where in Washington is DR. RODERICK BLAIR BEAZER (O.D.) registered?
Use Lake Stevens, Washington as the headline location for DR. RODERICK BLAIR BEAZER (O.D.) here.
Does DR. RODERICK BLAIR BEAZER (O.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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