Ayla Jade Himmelsbach, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3649ATI Issued in OR

Practice address

7826 SW Capitol Hwy
Portland, OR 97219-2466

Phone

(503) 224-7788

NPI assigned

Oct 10, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Ayla Jade Davis Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (5 of 7)

Locations

Networks

• WA PPO C-SNP
• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Meganeko LLC

  • Optometrist
  • Portland, OR
  • NPI 1184387532
  Medicare reassignment NPD Authorized official
• Atlas Eye Group LLC

  • Optometrist
  • Portland, OR
  • NPI 1376903328
  Medicare reassignment NPD
• Atlas Eye Group LLC

  • Optometrist
  • Troutdale, OR
  • NPI 1811438286
  NPD
• Double Vision Inc

  • Optometrist
  • Happy Valley, OR
  • NPI 1508037607
  NPD
• Spectrum Eye Care LLC

  • Optometrist
  • Happy Valley, OR
  • NPI 1043969579
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1003168337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7826 SW CAPITOL HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972192466",
            "telephone_number": "503-244-7788",
            "fax_number": "503-244-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7826 SW CAPITOL HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972192466",
            "telephone_number": "503-224-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMMELSBACH",
        "first_name": "AYLA",
        "middle_name": "JADE",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3649ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AYLA",
            "last_name": "DAVIS",
            "middle_name": "JADE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bethany Himes
• Debra Cordie Himes, LPTA
• Elise Madline Himes
• Patricia Himes, M.S.
• Benjamin Himley
• Janiece Marie Hinckley, PT
• Amber Hincks, L.AC.
• Cory Hincks
• Ingeborg Hindel, MD
• Daniel Ryan Hinderliter, FNP-C

• All providers in Portland, OR
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.