Individual provider Active NPI

Lance Gene Anderson, OD

  • Optometrist
  • Hillsboro, OR
National Provider Identifier
1083726855
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2298 ATI Issued in OR
Practice address
2037 NW 185TH Ave
Hillsboro, OR 97124-7073
Phone
(503) 690-9200
Fax
(503) 690-6189
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2298 ATI OR Primary

Addresses

Primary practice location

2037 NW 185TH Ave
Hillsboro, OR 97124-7073

Mailing address

2037 NW 185TH Ave
Hillsboro, OR 97124-7073
Phone (503) 690-9200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120321000804 OR Practitioner - Optometry 4183884570 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2298 ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Accent Inc. Optometrist CurrentSince Jan 1, 2012 Accepting new patients
Vision Accent Inc. Optometrist CurrentSince Apr 3, 2017 Accepting new patients

Locations

1981 NW 185th Ave
Hillsboro, OR 97124
Phone (503) 690-9200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1083726855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 NW 185TH AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971247073",
            "telephone_number": "503-690-9200",
            "fax_number": "503-690-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2037 NW 185TH AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971247073",
            "telephone_number": "503-690-9200",
            "fax_number": "503-690-6189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LANCE",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2298 ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.