Randall J. McClellan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3180AT Issued in OR

Practice address

14406 NE 20TH Ave
Vancouver, WA 98686-1448

Phone

(360) 571-3084

Fax

(360) 571-3082

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

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 2

Specialty

Optometry

Education

Southern California College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Northwest

  • Radiation Oncology Clinic/Center
  • Portland, OR
  • NPI 1093043424
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Pacific University

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1912377193
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1215947932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14406 NE 20TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861448",
            "telephone_number": "360-571-3084",
            "fax_number": "360-571-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14406 NE 20TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861448",
            "telephone_number": "360-571-3084",
            "fax_number": "360-571-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "RANDALL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3180AT",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OR",
            "license": "3180AT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240203",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey McChesney
• Nichole Mark McClafferty, LPN
• Sandra McClafferty
• Grace McClanahan
• Kristen McClellan, DC
• Ryan J McCloskey, PHARMD
• Lawrance H McClung, LICSW
• Gabrielle Lynn McClure
• Robyn Dawn McClure, LMP
• Samuel Patrick McClure, RPH

• Optometrist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.