Deschutes Eye Clinic Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

071581 Issued in OR

Legal business name

DESCHUTES EYE CLINIC INC

Doing business as

Eye Surgery Institute

Practice address

1775 SW Umatilla Ave
Redmond, OR 97756-7197

Phone

(541) 548-7170

Fax

(541) 548-3842

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Oli Traustason, M.D.NPI 1023019502

Title

President

Phone

(541) 548-7170

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Eye Surgery Institute Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Deschutes Eye Clinic PCCCN 38C0001023

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Oli I Traustason, M.D.

  • Ophthalmology Physician
  • Redmond, OR
  • NPI 1023019502
  Medicare reassignment Authorized official
• Kristine E Traustason, MD.

  • Ophthalmology Physician
  • Redmond, OR
  • NPI 1659396711
  NPD (past)
• Andrew Holt Pilling, MD

  • Ophthalmology Physician
  • Buffalo, NY
  • NPI 1558920249
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1063635506",
    "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": {
        "organization_name": "DESCHUTES EYE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "TRAUSTASON",
        "authorized_official_first_name": "OLI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-548-7170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "071581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PARTICIPATING",
            "identifier": "138874101",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "490003253",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE RR",
            "identifier": "180029258",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165450",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Surgery Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eye Surgery Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Del Mar, SLP-CCC
• Rachel Elizabeth Delance
• Julia Delbeccaro
• Christina Dellera-Storo
• Justin P Dennery, N.P.
• Deschutes Eye Clinic PC (The Eye Surgery Institute)
• Deschutes Laser Therapy. LLC
• Desert Bone & Joint Specialists LLP (Desert Orthopedics)
• Desert Peaks Health Care, LLC
• James K Detwiler, MD

• Ambulatory Surgical Clinic/Center in Redmond, OR
• Providers in Redmond, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.