NPIMap

Organization Active NPI

Sunset Vision Center LLC

  • Optometrist
  • Hillsboro, OR
National Provider Identifier
1104997659
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SUNSET VISION CENTER LLC
Practice address
22075 NW Imbrie Dr
Suite 101
Hillsboro, OR 97124-6993
Phone
(503) 844-6858
Fax
(503) 844-6850
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Authorized official

Name
Dr. Kenny Benjamin Lee, O.DNPI 1619905866
Title
Partner
Phone
(503) 844-6858

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: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

22075 NW Imbrie Dr
Suite 101
Hillsboro, OR 97124-6993

Mailing address

22075 NW Imbrie Dr
Suite 101
Hillsboro, OR 97124-6993
Phone (503) 844-6858

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090807000155 OR Part B Supplier - Clinic/Group Practice 9830242924 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Hillsboro, OR

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1104997659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22075 NW IMBRIE DR",
            "address_2": "SUITE 101",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971246993",
            "telephone_number": "503-844-6858",
            "fax_number": "503-844-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22075 NW IMBRIE DR",
            "address_2": "SUITE 101",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971246993",
            "telephone_number": "503-844-6858",
            "fax_number": "503-844-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSET VISION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "503-844-6858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.