NPIMap

Organization Active NPI

Central Oregon Eyecare, PC

  • Optometrist
  • Redmond, OR
National Provider Identifier
1073715157
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2823ATI Issued in OR
Legal business name
CENTRAL OREGON EYECARE, PC
Practice address
1000 SW Indian Ave
Redmond, OR 97756
Phone
(541) 548-2488
Fax
(541) 548-5334
NPI assigned
Jun 1, 2007
Last updated
Sep 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Daniel Vidlak, OD
Title
President
Phone
(541) 592-3921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2823ATI OR Primary

Addresses

Primary practice location

1000 SW Indian Ave
Redmond, OR 97756

Mailing address

1000 SW Indian Ave
Redmond, OR 97756-3039
Phone (541) 548-2488

Other practice location 1

65 NE Oak St Ste 110
Madras, OR 97741-1814
Phone (541) 475-9999

Other practice location 2

2155 NW Shevlin Park Rd
Bend, OR 97703-7101
Phone (541) 647-2760

Other practice location 3

198 NE Combs Flat Rd Ste 120
Prineville, OR 97754-2563
Phone (541) 447-5133

Other practice location 4

625 N Arrowleaf Trl Ste 103
Sisters, OR 97759-2610
Phone (541) 549-2105

Other identifiers 2

IdentifierTypeStateIssuer
U85325MedicaidOR
230762MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040302000211 OR Part B Supplier - Clinic/Group Practice 8426945783 Receives reassigned benefits from 13 practitioners
4 other NPIs on this enrollment
Practice locations: Bend, OR; Madras, OR; Prineville, OR; Redmond, OR; Sisters, OR

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2121519Central Oregon Eyecare1000 SW Indian Ave, Redmond, OR 97756Certificate of waiverNov 6, 2026
38D2132771Central Oregon Eyecare65 NE Oak Street Suite 110, Madras, OR 97741Certificate of waiverJun 26, 2027
38D2132786Central Oregon Eyecare2155 NW Shevlin Park Rd, Bend, OR 97703Certificate of waiverJun 26, 2027

National Provider Directory

National Provider Directory

Locations

2155 NW Shevlin Park Rd
Bend, OR 97703
Phone (541) 647-2760

198 NE Combs Flat Rd
Ste 120
Prineville, OR 97754
Phone (541) 447-5133

625 N Arrowleaf Trl
Ste 110
Sisters, OR 97759

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1073715157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SW INDIAN AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977563039",
            "telephone_number": "541-548-2488",
            "fax_number": "541-548-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SW INDIAN AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "97756",
            "telephone_number": "541-548-2488",
            "fax_number": "541-548-5334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 NE Oak St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Madras",
            "state": "OR",
            "postal_code": "977411814",
            "country_code": "US",
            "telephone_number": "541-475-9999",
            "fax_number": "541-475-4247",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2155 NW Shevlin Park Rd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977037101",
            "country_code": "US",
            "telephone_number": "541-647-2760",
            "fax_number": "541-647-2763",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "198 NE Combs Flat Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Prineville",
            "state": "OR",
            "postal_code": "977542563",
            "country_code": "US",
            "telephone_number": "541-447-5133",
            "fax_number": "541-447-6891",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 N Arrowleaf Trl Ste 103",
            "address_purpose": "LOCATION",
            "city": "Sisters",
            "state": "OR",
            "postal_code": "977592610",
            "country_code": "US",
            "telephone_number": "541-549-2105",
            "fax_number": "541-549-2106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL OREGON EYECARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "VIDLAK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-592-3921",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2823ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "U85325",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230762",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.