Active NPI
Joseph J Kvortek, OD
- Optometrist
- Bend, OR
National Provider Identifier
1063623221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1047T
- Practice address
- 3044 N Highway 97
Bend, OR 97701-7512 - Phone
- (541) 388-5716
- Fax
- (541) 617-7898
- NPI assigned
- May 26, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1047T | OR | Primary |
Addresses
Primary practice location
3044 N Highway 97
Bend, OR 97701-7512
Mailing address
1691 NW Pinecrest Dr
Prineville, OR 97754-7750
Phone (541) 447-4739
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1047T | OR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc | Past | Accepting new patients |
Organizations & group practices 1
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": "1180137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063623221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1691 NW PINECREST DR",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977547750",
"telephone_number": "541-447-4739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3044 N HIGHWAY 97",
"city": "BEND",
"state": "OR",
"postal_code": "977017512",
"telephone_number": "541-388-5716",
"fax_number": "541-617-7898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KVORTEK",
"first_name": "JOSEPH",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "1047T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.