NPIMap

Organization Active NPI

Oregon Optometry and Contact Lenses LLC

  • Optometrist
  • Tigard, OR
National Provider Identifier
1104500651
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OREGON OPTOMETRY AND CONTACT LENSES LLC
Practice address
10225 SW Hall Blvd
Tigard, OR 97223-8855
Phone
(503) 244-1004
NPI assigned
Jun 14, 2023
Last updated
May 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Dr. Jenna McBride, ODNPI 1952890097
Title
Optometrist/Owner
Phone
(408) 823-5312

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

10225 SW Hall Blvd
Tigard, OR 97223-8855

Mailing address

10225 SW Hall Blvd
Tigard, OR 97223-8855
Phone (503) 244-1004

Other names 1

  • Jenna McBride OD LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230801002081 OR Part B Supplier - Clinic/Group Practice 6901267442 Receives reassigned benefits from 3 practitioners
Practice locations: Tigard, OR

National Provider Directory

National Provider Directory

Locations

10225 SW Hall Blvd
Tigard, OR 97223
Phone (503) 244-1004

10225 SW Hall Blvd
Ste 101
Tigard, OR 97223
Phone (503) 244-1004

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1104500651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10225 SW HALL BLVD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238855",
            "telephone_number": "503-244-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10225 SW HALL BLVD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238855",
            "telephone_number": "503-244-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON OPTOMETRY AND CONTACT LENSES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2024-05-30",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "JENNA",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "408-823-5312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jenna McBride OD LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.