NPIMap

Organization Active NPI

Vancouver Contact Lens & Vision Clinic Inc

  • Optometrist
  • Camas, WA
National Provider Identifier
1124163167
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VANCOUVER CONTACT LENS & VISION CLINIC INC
Practice address
329 NE 6TH Ave
Camas, WA 98607-2035
Phone
(360) 834-4802
Fax
(360) 834-7046
NPI assigned
Feb 20, 2007
Last updated
Jul 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Rajiv Patel, ODNPI 1548342058
Title
President
Phone
(360) 694-8303

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 MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

329 NE 6TH Ave
Camas, WA 98607-2035

Mailing address

329 NE 6TH Ave
Camas, WA 98607-2035
Phone (360) 834-4802

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040302000282 WA Part B Supplier - Clinic/Group Practice 2668369935 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Camas, WA; Vancouver, WA

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
Tax ID family
Vancouver Cntct Lensvsn CLN2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

314 E McLoughlin Blvd
Vancouver, WA 98663
Phone (360) 694-8303

Practitioners & affiliated clinicians

Practitioners 12

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1124163167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 NE 6TH AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072035",
            "telephone_number": "360-834-4802",
            "fax_number": "360-834-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 NE 6TH AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072035",
            "telephone_number": "360-834-4802",
            "fax_number": "360-834-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCOUVER CONTACT LENS & VISION CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RAJIV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-694-8303",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camas, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.