Active NPI
Amy Roseanne Skucas, DO00002207
- Optician
- Portland, OR
National Provider Identifier
1235306911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO00002207
- Practice address
- 500 Multnomah St
Suite 100
Portland, OR 97232 - Phone
- (503) 571-5675
- NPI assigned
- May 13, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DO00002207 | WA | Primary |
Addresses
Primary practice location
500 Multnomah St
Suite 100
Portland, OR 97232
Mailing address
PO Box 213
Yacolt, WA 98675
Phone (360) 903-9717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DO00002207 | Other | WA | WASHINGTON STATE LICENSED DISPENSING OPTICIAN |
Other names 1
- Amy Roseanne Lugo
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO00002207 | WA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268006400000",
"number": "1235306911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 213",
"city": "YACOLT",
"state": "WA",
"postal_code": "98675",
"telephone_number": "360-903-9717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 MULTNOMAH ST",
"address_2": "SUITE 100",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97232",
"telephone_number": "503-571-5675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKUCAS",
"first_name": "AMY",
"middle_name": "ROSEANNE",
"credential": "DO00002207",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-13",
"last_updated": "2010-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "WA",
"license": "DO00002207",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE LICENSED DISPENSING OPTICIAN",
"identifier": "DO00002207",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "LUGO",
"middle_name": "ROSEANNE",
"code": "5",
"type": "Other Name"
}
]
}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 Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.