Aazy A Aaby, MD

Individual provider Active NPI Ophthalmology Physician · Portland, OR

NPI 1164404232 · NPPES record last updated Nov 17, 2009

Key facts

NPI
1164404232
Entity type
Individual (NPI type 1)
Primary specialty
Ophthalmology Physician 207W00000X
License
MD14578 (OR)
Practice address
1955 NW Northrup St
Portland, OR 97209-1614
Phone
(503) 227-2020
Fax
(503) 222-0614
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD14578ORMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Health Northwest Optical, LLC Past
since Jan 18, 1999
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD14578 OR Yes

Addresses

Primary practice location

1955 NW Northrup St
Portland, OR 97209-1614

Mailing address

11086 SE Oak St
Milwaukie, OR 97222-6692
Phone (503) 557-2020

Other identifiers

IdentifierTypeStateIssuer
142315MedicaidOR

Other providers in Portland, OR

All providers in Portland, OR · Ophthalmology Physician in Oregon

Sources for this page

Verify at the official NPI Registry.