NPIMap

Organization Active NPI

Gatti Vision LLC

  • Optometrist
  • King City, OR
National Provider Identifier
1083246292
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GATTI VISION LLC
Practice address
15405 SW 116TH Ave Ste 204
King City, OR 97224-4101
Phone
(971) 371-3927
Fax
(888) 411-0427
NPI assigned
Feb 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Alex Heiberg
Title
Office Manager
Phone
(971) 371-3927

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary
Corneal and Contact Management OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WC0802X
Pediatric OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WP0200X
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X

Addresses

Primary practice location

15405 SW 116TH Ave Ste 204
King City, OR 97224-4101

Mailing address

15405 SW 116TH Ave Ste 204
King City, OR 97224-4101
Phone (971) 371-3927

Other names 1

  • Gatti Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200324000707 OR Part B Supplier - Clinic/Group Practice 7618305764 Receives reassigned benefits from 3 practitioners
Practice locations: King City, OR

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
38D2180839Gatti Vision15405 SW 116TH Ave, Suite 204, King City, OR 97224Certificate of waiverMar 19, 2028

National Provider Directory

National Provider Directory

Locations

15405 SW 116th Ave
Ste 204
Portland, OR 97224
Phone (503) 620-4070

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1083246292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15405 SW 116TH AVE STE 204",
            "city": "KING CITY",
            "state": "OR",
            "postal_code": "972244101",
            "telephone_number": "971-371-3927",
            "fax_number": "888-411-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15405 SW 116TH AVE STE 204",
            "city": "KING CITY",
            "state": "OR",
            "postal_code": "972244101",
            "telephone_number": "971-371-3927",
            "fax_number": "888-411-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATTI VISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "HEIBERG",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "971-371-3927"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gatti Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in King City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.