Active NPI
Jared S Nuffer, O.D.
- Optometrist
- Portland, OR
National Provider Identifier
1225147408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1608 ATI
- Practice address
- 19500 SE Stark St
Portland, OR 97233-5757 - Phone
- (503) 669-3900
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1608 ATI | OR | Primary |
| Optometrist | 152W00000X | 1821 | WA | |
| Corneal and Contact Management Optometrist | 152WC0802X | 1608 ATI | OR |
Addresses
Primary practice location
19500 SE Stark St
Portland, OR 97233-5757
Mailing address
19500 SE Stark St
Portland, OR 97233-5757
Phone (503) 407-2806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1608 ATI | OR | MD | Corneal and Contact Management Optometrist |
| 1821 | WA | MD | Interpreter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461110400000",
"number": "1225147408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19500 SE STARK ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972335757",
"telephone_number": "503-407-2806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19500 SE STARK ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972335757",
"telephone_number": "503-669-3900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUFFER",
"first_name": "JARED",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2016-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "1608 ATI",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "1821",
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "OR",
"license": "1608 ATI",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.