Individual provider Active NPI

Ryan Gorger, OD

  • Optometrist
  • Portland, OR
National Provider Identifier
1164537981
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3209ATI Issued in OR
Practice address
800 SW 13TH Ave
Portland, OR 97205-1999
Phone
(503) 221-0161
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3209ATI OR Primary

Addresses

Primary practice location

800 SW 13TH Ave
Portland, OR 97205-1999

Mailing address

800 SW 13TH Ave
Portland, OR 97205-1999
Phone (503) 221-0161

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rgorger4871@direct.theportlandclinic.net

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
I20090212000489 OR Practitioner - Optometry 1153423405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland ClinicGroup PAC ID 8224942867, 93 clinicians

Practice addresses (Care Compare)

800 SW 13TH Ave
Portland, OR 97205-1902
Phone 50322101612110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2485OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Clinic CurrentSince Nov 1, 2014 Accepting new patients
The Portland Clinic Laboratory Current Accepting new patients
Cherokee Nation PastSince Mar 1, 2021 Accepting new patients
Cherokee Nation Past Accepting new patients
Northeastern State University College of Optometry Optometrist PastSince Jul 1, 2025 Accepting new patients
Murray Scholls Optique Inc Optometrist PastSince Apr 19, 2011 Accepting new patients

Locations

15950 SW Millikan Way
Beaverton, OR 97003
Phone (503) 646-0161

541 NE 20th Ave
Ste 210
Portland, OR 97232
Phone (503) 233-6940

6640 SW Redwood Ln
Portland, OR 97224
Phone (503) 620-7358

800 SW 13th Ave
Ste 151
Portland, OR 97205

800 SW 13th Ave
Portland, OR 97205
Phone (503) 221-0161

9250 SW Hall Blvd
Tigard, OR 97223
Phone (503) 221-0161

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/
  • Direct secure messaging: rgorger32059@theportlandclinic.gardenplot.direct-ci.com

Organizations & group practices 6

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1164537981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051999",
            "telephone_number": "503-221-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051999",
            "telephone_number": "503-221-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORGER",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3209ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgorger4871@direct.theportlandclinic.net",
            "affiliation": "N",
            "address_1": "800 SW 13th Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972051999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.