Individual provider Active NPI

Michael D Klautzsch, OD

  • Optometrist
  • Bend, OR
National Provider Identifier
1164601167
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2515ATI Issued in OR
Practice address
1470 SW Knoll Ave Ste 102
Bend, OR 97702-3154
Phone
(541) 797-0295
NPI assigned
Oct 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2515ATI OR Primary

Addresses

Primary practice location

1470 SW Knoll Ave Ste 102
Bend, OR 97702-3154

Mailing address

1470 SW Knoll Ave Ste 102
Bend, OR 97702-3154
Phone (541) 797-0295

Other identifiers 4

IdentifierTypeStateIssuer
079328000OtherORREGENCE BLUE CROSS
079328001OtherORRBCBS MED ADVANTAGE
074950MedicaidOR
079327001OtherORBLUE CROSS

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
I20100824000477 OR Practitioner - Optometry 0547384836 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1470 SW Knoll Ave
Suite 102
Bend, OR 97702-3154
Phone (541) 797-0295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2515ORMDClinical Psychologist
2515ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Care of Oregon Optometrist CurrentSince Apr 4, 2024 Accepting new patients
Bend Family Vision Care LLC Optometrist CurrentSince Jan 28, 2024 Accepting new patients
All Family Vision LLC Optometrist CurrentSince Jan 1, 2012 Accepting new patients
Optometric Care of Oregon Optometrist CurrentSince Apr 4, 2024 Accepting new patients

Locations

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

1470 SW Knoll Ave
Ste 102
Bend, OR 97702
Phone (503) 329-1696

1597 SW 53rd St
Corvallis, OR 97333
Phone (541) 757-8844

207 Coburg Rd
Ste 105
Eugene, OR 97401
Phone (541) 338-4844

22640 SE Stark St
Gresham, OR 97030
Phone (503) 667-0441

1810 Summer St NE
Salem, OR 97301
Phone (503) 364-0767

Organizations & group practices 4

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": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1164601167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 SW KNOLL AVE STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023154",
            "telephone_number": "541-797-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 SW KNOLL AVE STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023154",
            "telephone_number": "541-797-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAUTZSCH",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2515ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS",
            "identifier": "079328000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBCBS MED ADVANTAGE",
            "identifier": "079328001",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074950",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "079327001",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.