Individual provider Active NPI

Gurdas Mann, OD

  • Optometrist
  • Gresham, OR
National Provider Identifier
1033008222
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AT4772 Issued in OR
Practice address
2474 SE Burnside Rd
Gresham, OR 97080-1247
Phone
(503) 489-5771
Fax
(503) 489-5778
NPI assigned
Jul 1, 2025
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AT4772 OR Primary

Addresses

Primary practice location

2474 SE Burnside Rd
Gresham, OR 97080-1247

Mailing address

2474 SE Burnside Rd
Gresham, OR 97080-1247
Phone (503) 489-5771

Other practice location 1

36840 Industrial Way Ste D
Sandy, OR 97055-9254
Phone (503) 482-0475

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
I20250915003948 OR Practitioner - Optometry 4981108891 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aa Vision CorporationGroup PAC ID 4981016649, 2 clinicians

Practice addresses (Care Compare)

2474 SE Burnside Rd
Gresham, OR 97080-1247
Phone (503) 489-5771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT4772ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mt. Hood Eye Care Corporation Optometrist CurrentSince Sep 1, 2025 Accepting new patients
Aa Vision Corporation Optometrist CurrentSince Jul 3, 2025 Accepting new patients
Kat Eye Corporation Optometrist CurrentSince Sep 1, 2025 Accepting new patients

Locations

21825 SE Stark St
Ste B
Gresham, OR 97030
Phone (503) 492-2020

2474 SE Burnside Rd
Gresham, OR 97080
Phone (402) 366-8402

36840 Industrial Way
Ste D
Sandy, OR 97055
Phone (503) 482-0475

Networks

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

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": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1033008222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2474 SE BURNSIDE RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801247",
            "telephone_number": "503-489-5771",
            "fax_number": "503-489-5778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2474 SE BURNSIDE RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801247",
            "telephone_number": "503-489-5771",
            "fax_number": "503-489-5778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36840 Industrial Way Ste D",
            "address_purpose": "LOCATION",
            "city": "Sandy",
            "state": "OR",
            "postal_code": "970559254",
            "country_code": "US",
            "telephone_number": "503-482-0475",
            "fax_number": "503-482-0476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "GURDAS",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "AT4772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.