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Active NPI 1366522633 Individual Practitioner Female Practitioner

Dr. Angelica Rose Sup , OD

Optometrist • Edmonds, WA

Professional Overview & Biography Verified Profile Summary

Dr. Angelica Sup, OD is a registered healthcare professional specializing in Optometrist in Edmonds, WA. Practice services are available at 21911 76TH AVE W under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

21911 76th Ave W
Suite 101

Edmonds, WA 980267903

Telephone 4257747723
Fax 4257782788
Associated Practice Facility / Clinic
🏢 Samuel K. Seto Md Pllc Facility NPI 1497827711

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Edmonds, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 29.0 Yrs
State Avg: 20.4 Yrs
Regional Practice Density
11 Specialists

Practicing in Edmonds, WA (1692 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License WA OD00003975

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID L&i Provider Number
0202735 (WA)
Commercial Insurance / Payer ID Regence Provider Number
2161SU (WA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1144300542

Doctor of Medicine (M.D.)

Steven Seto

Ophthalmology

NPI 1861029399

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 21911 76TH AVE W, SUITE 101, EDMONDS, WA 980267903 (Tel: 4257747723)

📍
Updated Business Mailing Address July 09, 2007

Registered at 21911 76TH AVE W, SUITE 101, EDMONDS, WA 980267903 (Tel: 4257747723)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as ANGELICA SUP, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Optometrist (License #OD00003975 in WA)

🟢
Initial NPI Registration & Enumeration October 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1366522633
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 17, 2006
Last Update: July 09, 2007
Sole Proprietor: No

Mailing Address

21911 76th Ave W, Suite 101

Edmonds, WA 980267903

Phone: 4257747723

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.