Alexa Nicole Thavorn I, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ATI4556 Issued in OR

Practice address

11805 NW Cedar Falls Dr Ste 105
Portland, OR 97229-2780

Phone

(503) 747-0265

NPI assigned

Feb 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hoban Vision IncGroup PAC ID 2365877586, 9 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Hoban Vision, Inc.

  • Optometrist
  • Portland, OR
  • NPI 1285271551
  Medicare reassignment Care Compare group NPD
• Thomas M. Barreto, O.D., P.C.

  • Optometrist
  • Portland, OR
  • NPI 1174662951
  Medicare reassignment NPD

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1083205074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 NE 7TH AVE APT 404",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123179",
            "telephone_number": "714-478-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11805 NW CEDAR FALLS DR STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972292780",
            "telephone_number": "503-747-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAVORN",
        "first_name": "ALEXA",
        "middle_name": "NICOLE",
        "name_suffix": "I",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Michael Thatcher
• Carl Thatcher, PT
• Francoise Andree Thatcher, CDAC R
• Jessica Lauren Thatcher
• Katrina Thatcher, MS, LPC
• Rajat Thawani, MD
• James Robert Thayer, MD
• Sue Thayer, CADC I
• THCF
• The Art of Balance LLC

• Optometrist in Portland, OR
• Providers in Portland, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.