| Pacific Northwest Retina Pllc | |
|
1750 112th Ave Ne Ste D050 Bellevue WA 98004-3779 | |
| (206) 215-3850 | |
| (206) 215-3870 |
| Full Name | Pacific Northwest Retina Pllc |
|---|---|
| Speciality | Ophthalmology |
| Location | 1750 112th Ave Ne Ste D050, Bellevue, Washington |
| Authorized Official Name and Position | Charles D Birnbach (SECRETARY) |
| Authorized Official Contact | 4252963837 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Northwest Retina Pllc 1750 112th Ave Ne Ste D050 Bellevue WA 98004-3779 Ph: (206) 215-3850 | Pacific Northwest Retina Pllc 1750 112th Ave Ne Ste D050 Bellevue WA 98004-3779 Ph: (206) 215-3850 |
| NPI Number | 1558940387 |
|---|---|
| Provider Enumeration Date | 04/07/2021 |
| Last Update Date | 08/21/2023 |
| Medicare PECOS PAC ID | 8820494073 |
|---|---|
| Medicare Enrollment ID | O20210930001457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558940387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 207WX0107X | Ophthalmology - Retina Specialist | (* (Not Available)) | Primary |
| Provider Name | Brenda A Myers Powell |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1356325195 PECOS PAC ID: 8123012622 Enrollment ID: I20040408000879 |
| Provider Name | Steve H Kim |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457408064 PECOS PAC ID: 5698660850 Enrollment ID: I20040611001151 |
| Provider Name | Charles D Birnbach |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1144255936 PECOS PAC ID: 3173504859 Enrollment ID: I20040623000011 |
| Provider Name | Todd E Schneiderman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1033141007 PECOS PAC ID: 7012953102 Enrollment ID: I20050629000302 |
| Provider Name | David J Spinak |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1942232913 PECOS PAC ID: 1153347281 Enrollment ID: I20051018001184 |
| Provider Name | David A Saperstein |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1508946625 PECOS PAC ID: 8921009945 Enrollment ID: I20070118000040 |
| Provider Name | Andrew S Barloon |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457350670 PECOS PAC ID: 6204721103 Enrollment ID: I20071219000770 |
| Provider Name | Tony Huu Huynh |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1669590782 PECOS PAC ID: 0143312389 Enrollment ID: I20090717000398 |
| Provider Name | Todd Robert Klesert |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1386706174 PECOS PAC ID: 2062427958 Enrollment ID: I20100111000486 |
| Provider Name | Adrian E Omalley |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1295729010 PECOS PAC ID: 0840281796 Enrollment ID: I20100623001018 |
| Provider Name | Robert W Nash |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1649279456 PECOS PAC ID: 6507981636 Enrollment ID: I20100914000142 |
| Provider Name | Yicheng Chen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1124314653 PECOS PAC ID: 9436460763 Enrollment ID: I20170828001243 |
| Provider Name | Cindy Wei Mi |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1952692410 PECOS PAC ID: 3173842267 Enrollment ID: I20170901001936 |
| Provider Name | Amy E Yuan |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1528417813 PECOS PAC ID: 8820384274 Enrollment ID: I20200512001476 |
| Provider Name | Eric Hansen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1912260456 PECOS PAC ID: 8527351725 Enrollment ID: I20240425003785 |
| Provider Name | Nicolaas Piet Deruyter |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1972000602 PECOS PAC ID: 8224418751 Enrollment ID: I20240819004045 |
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