Samuel Edward Adelman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3462ATI Issued in OR

Practice address

11800 SE 82ND Ave
Happy Valley, OR 97086-7711

Phone

(503) 660-3093

Fax

(503) 654-5429

NPI assigned

Oct 7, 2009

Last updated

Jan 31, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2012

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

Locations

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.

• Oizu Optic LLC

  dba Portland Eye Care

  • Optometrist
  • Portland, OR
  • NPI 1295158301
  Medicare reassignment NPD Authorized official
• Sustainable Vision LLC

  dba Portland Eye Care

  • Optometrist
  • Happy Valley, OR
  • NPI 1689914400
  Authorized official Same address or phone

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1043545122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86221",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972860221",
            "telephone_number": "971-263-0495",
            "fax_number": "503-654-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 SE 82ND AVE",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970867711",
            "telephone_number": "503-660-3093",
            "fax_number": "503-654-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELMAN",
        "first_name": "SAMUEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-07",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3462ATI",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 60290877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole Abbey Abajian, LCSW
• Aaron Abraham
• Advanced Sleep Health, LLC
• Advanced Sleep Health, LLC
• Aegis Group Practice LLC
• Merrie-Chris Agag
• Airway Dental Group LLC

• Optometrist in Happy Valley, OR
• Providers in Happy Valley, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.