Individual provider Active NPI

Chelsea Nicole Territo, OD

  • Optometrist
  • Beaverton, OR
National Provider Identifier
1003475625
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4466 Issued in OR
Practice address
18070 NW Evergreen Pkwy
Beaverton, OR 97006-7451
Phone
(971) 348-3174
Fax
(503) 439-8862
NPI assigned
Jun 7, 2019
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4466 OR Primary

Addresses

Primary practice location

18070 NW Evergreen Pkwy
Beaverton, OR 97006-7451

Mailing address

18070 NW Evergreen Pkwy
Beaverton, OR 97006-7451

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190731002242 OR Practitioner - Optometry 9537495379 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Hills Eye Clinic LLCGroup PAC ID 1254810054, 2 clinicians
Nimbus Vision Clinic, LLCGroup PAC ID 6204822620, 2 clinicians

Practice addresses (Care Compare)

8566 SW Apple Way
Portland, OR 97225-1772
Phone (503) 297-4183

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4466ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Oregon Eyecare, PC Optometrist CurrentSince Jun 17, 2019 Accepting new patients
Central Oregon Eyecare, PC Optometrist Current Accepting new patients
Molalla Vision Clinic PC Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Raleigh Hills Eye Clinic, LLC Optometrist CurrentSince Jan 15, 2026 Accepting new patients
Nimbus Vision Clinic, LLC Optometrist CurrentSince Mar 23, 2022 Accepting new patients
Central Oregon Eyecare, PC Optometrist CurrentSince Jun 17, 2019 Accepting new patients
Hastings Vision Clinic, P.C. Optometrist Past Accepting new patients
Methodist Medical Center of Illinois PastSince Jan 1, 2022 Accepting new patients

Locations

502 E Main St
Molalla, OR 97038
Phone (503) 829-9186

8566 SW Apple Way
Portland, OR 97225
Phone (503) 297-4183

1000 SW Indian Ave
Redmond, OR 97756
Phone (541) 548-2488

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1003475625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18070 NW EVERGREEN PKWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18070 NW EVERGREEN PKWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067451",
            "telephone_number": "971-348-3174",
            "fax_number": "503-439-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRITO",
        "first_name": "CHELSEA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.