PACIFIC NORTHWEST RETINA PLLC – Retina Specialist (Ophthalmology) Physician, NPI 1558940387
Retina Specialist (Ophthalmology) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PACIFIC NORTHWEST RETINA PLLC
215 E George Hopper Rd
Burlington, WA 982333105
Phone: (206) 215-3850
Type: Location
2205 W Dolarway Rd Ste 2
Ellensburg, WA 989268241
Phone: (206) 215-3850
Type: Location
3105 Old Fairhaven Pkwy Ste 103
Bellingham, WA 982258212
Phone: (206) 215-3850
Type: Location
6100 219th St SW Ste 280
Mountlake Terrace, WA 980432222
Phone: (206) 215-3850
Type: Location
1229 Madison St Ste 620
Seattle, WA 981043304
Phone: (206) 215-3850
Type: Location
321 Ramsay Way Ste 107
Kent, WA 980324544
Phone: (206) 215-3850
Type: Location
1750 112TH AVE NE STE D050
BELLEVUE, WA 980043779
Phone: (206) 215-3850
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: 2021-09-30
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 |
|---|---|---|---|---|
| O20210930001457 | O | Clinic/Group Practice | 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 98233)
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