EVERGREEN EYE CENTER, PLLC – Ambulatory Surgical Clinic/Center, NPI 1104465012
Ambulatory Surgical Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for EVERGREEN EYE CENTER, PLLC
502 S M ST
TACOMA, WA 984053728
Phone: (206) 260-2503
Fax: (855) 929-1515
Type: Mailing
PO BOX 25020
FEDERAL WAY, WA 980932020
Phone: (800) 340-3595
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2020-02-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-05-31 (11 days ago).
Enrollment records
1
Earliest due date
2026-05-31
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 |
|---|---|---|---|---|
| O20200219002868 | O | Ambulatory Surgical Center | WA | 2026-05-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 66984 | Removal of cataract with insertion of prosthetic lens | 362 | 211 | $0 |
| 66821 | Removal of recurring cataract in lens capsule using a laser | 139 | 101 | $0 |
| 66982 | Complex removal of cataract with insertion of prosthetic lens | 46 | 35 | $0 |
| 65820 | Incision to improve eye fluid flow | 32 | 19 | $0 |
| 65855 | Laser repair to improve eye fluid flow | 26 | 16 | $0 |
Insurance plans in this area (ZIP 98405)
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