Organization Active NPI

Schmidt Eyecare, LLC

  • Optometrist
  • Lake Oswego, OR
National Provider Identifier
1174916910
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3401AT Issued in OR
Legal business name
SCHMIDT EYECARE, LLC
Practice address
333 S State St Ste T
Lake Oswego, OR 97034-3948
Phone
(503) 636-2762
NPI assigned
Mar 17, 2015
Last updated
Mar 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Authorized official

Name
Dr. Kimberly Ann Schmidt, ODNPI 1861780785
Title
Optometrist/Owner
Phone
(503) 636-2762

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
Optometrist 152W00000X 3401AT OR Primary

Addresses

Primary practice location

333 S State St Ste T
Lake Oswego, OR 97034-3948

Mailing address

333 S State St Ste T
Lake Oswego, OR 97034-3948
Phone (503) 636-2762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151005001701 OR DME Supplier - Physician - OptometristDME Supplier - Optician 2365750742 Practice locations: Lake Oswego, OR
O20160210000656 OR Part B Supplier - Clinic/Group Practice 2365750742 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Oswego, OR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Schmidt Eyecare LLC333 S State St, Lake Oswego, OR 97034-3948(503) 636-2762 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2015

National Provider Directory

National Provider Directory

Locations

333 S State St
Ste T
Lake Oswego, OR 97034
Phone (503) 636-2762

Practitioners & affiliated clinicians

Practitioners 1

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": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1174916910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S STATE ST STE T",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343948",
            "telephone_number": "503-636-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S STATE ST STE T",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343948",
            "telephone_number": "503-636-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHMIDT EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "503-636-2762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3401AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.