Individual provider Active NPI

Toby Lloyd Andreasen, OD

  • Optometrist
  • Hillsboro, OR
National Provider Identifier
1174517098
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2992ATI Issued in OR
Practice address
5317 W Baseline Rd
Hillsboro, OR 97123-6447
Phone
(503) 648-5522
Fax
(503) 844-9334
NPI assigned
Sep 7, 2005
Last updated
Mar 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2992ATI OR Primary

Addresses

Primary practice location

5317 W Baseline Rd
Hillsboro, OR 97123-6447

Mailing address

5317 W Baseline Rd
Hillsboro, OR 97123-6447
Phone (503) 648-5522

Other identifiers 2

IdentifierTypeStateIssuer
240391MedicaidOR
OD389ORMedicaidAK

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
I20041202000882 OR Practitioner - Optometry 2961468814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drew M. Perry, O D., Inc.Group PAC ID 7416052261, 3 clinicians

Practice addresses (Care Compare)

5317 E Main St
Hillsboro, OR 97123-6447
Phone (503) 648-5522

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2992ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Drew M Perry OD Inc CurrentSince Sep 1, 2006 Accepting new patients
Murray Scholls Optique Inc Optometrist PastSince Apr 19, 2011 Accepting new patients

Locations

5317 E Main St
Hillsboro, OR 97129
Phone (503) 648-5522

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1174517098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5317 W BASELINE RD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971236447",
            "telephone_number": "503-648-5522",
            "fax_number": "503-844-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5317 W BASELINE RD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971236447",
            "telephone_number": "503-648-5522",
            "fax_number": "503-844-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREASEN",
        "first_name": "TOBY",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2992ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240391",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD389OR",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.