Individual provider Active NPI

Oli I Traustason, M.D.

  • Ophthalmology Physician
  • Redmond, OR
National Provider Identifier
1023019502
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD09829 Issued in OR
Practice address
1775 SW Umatilla Ave
Redmond, OR 97756-7197
Phone
(541) 548-7170
Fax
(541) 548-3842
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD09829 OR Primary
Ophthalmology Physician 207W00000X MD00026268 WA
Ophthalmology Physician 207W00000X M-6100 ID
Ophthalmology Physician 207W00000X G33242 CA

Addresses

Primary practice location

1775 SW Umatilla Ave
Redmond, OR 97756-7197

Mailing address

1775 SW Umatilla Ave
Redmond, OR 97756-7197
Phone (541) 548-7170

Other identifiers 6

IdentifierTypeStateIssuer
10283OtherORCLEAR CHOICE
A009OtherORTRIWEST CHAMPUS
001193MedicaidOR
200225OtherORCOIHS
053857009OtherORREGENCE BCBS
180029258OtherORRAILROAD MEDICARE

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070913000828 OR Practitioner - Ophthalmology 7517061492 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G33242CAMDOphthalmology Physician
M-6100IDMDOphthalmology Physician
MD00026268WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orion Eye Center LLC Ophthalmology CurrentSince Jan 2, 2013 Accepting new patients

Locations

1475 SW Chandler Ave
Ste 102
Bend, OR 97702
Phone (541) 548-7170

1775 SW Umatilla Ave
Redmond, OR 97756
Phone (541) 548-7170

Organizations & group practices 3

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1023019502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 SW UMATILLA AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977567197",
            "telephone_number": "541-548-7170",
            "fax_number": "541-548-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 SW UMATILLA AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977567197",
            "telephone_number": "541-548-7170",
            "fax_number": "541-548-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUSTASON",
        "first_name": "OLI",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD09829",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00026268",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ID",
            "license": "M-6100",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G33242",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLEAR CHOICE",
            "identifier": "10283",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST CHAMPUS",
            "identifier": "A009",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001193",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COIHS",
            "identifier": "200225",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBS",
            "identifier": "053857009",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180029258",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.