NPIMap

Organization Active NPI

Myoptic Optometry, LLC

  • Point of Service
  • Portland, OR
National Provider Identifier
1235325333
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
3153AT Issued in OR
Legal business name
MYOPTIC OPTOMETRY, LLC
Practice address
3333 SE Belmont St
Portland, OR 97214-4244
Phone
(503) 335-7173
Fax
(503) 335-7973
NPI assigned
Sep 21, 2007
Last updated
Apr 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Authorized official

Name
Dr. Yuesum To, O.D.NPI 1144324732
Title
Optometrist
Phone
(503) 493-7070

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
Point of Service 305S00000X 3153AT OR Primary

Addresses

Primary practice location

3333 SE Belmont St
Portland, OR 97214-4244

Mailing address

3978 N Williams Ave
Portland, OR 97227-1445
Phone (503) 493-7070

Other names 1

  • Dr. Summy To, Optometry Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071011000682 OR Part B Supplier - Clinic/Group Practice 4183719701 Receives reassigned benefits from 14 practitioners
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

12 SE 28th Ave
Portland, OR 97214
Phone (503) 282-2020

3333 SE Belmont St
Portland, OR 97214
Phone (503) 335-7173

3978 N Williams Ave
Portland, OR 97227
Phone (503) 493-7070

8046 SE 13th Ave
Portland, OR 97202
Phone (503) 420-8689

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1235325333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3978 N WILLIAMS AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271445",
            "telephone_number": "503-493-7070",
            "fax_number": "503-715-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144244",
            "telephone_number": "503-335-7173",
            "fax_number": "503-335-7973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYOPTIC OPTOMETRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "TO",
        "authorized_official_first_name": "YUESUM",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "503-493-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "OR",
            "license": "3153AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Summy To, Optometry",
            "code": "4",
            "type": "Former Legal Business 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 Apr 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.