Individual provider Active NPI

Dominic Jerome Dorazio, O.D.

  • Optometrist
  • Happy Valley, OR
National Provider Identifier
1235656547
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AT4480 Issued in OR
Practice address
12050 SE Stevens Rd Ste 100
Happy Valley, OR 97086-7667
Phone
(503) 656-4221
NPI assigned
Aug 28, 2017
Last updated
Sep 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC7054 FL
Optometrist 152W00000X AT4480 OR Primary

Addresses

Primary practice location

12050 SE Stevens Rd Ste 100
Happy Valley, OR 97086-7667

Mailing address

1306 Division St
Oregon City, OR 97045-1523
Phone (503) 656-4221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180702001300 TX Practitioner - Optometry 2769738905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5 Dakota Dr
Suite 307
New Hyde Park, NY 11042-1106

7533 Daffodil Way
Frisco, TX 75033-3154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4480ORMDDentist
AT4480ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Eyecare, P.a. Optometrist CurrentSince Apr 8, 2021 Accepting new patients
University of Houston System Optometrist CurrentSince Jul 1, 2018 Accepting new patients
University of Houston CurrentSince Jul 1, 2018 Accepting new patients
University of Houston System Optometrist Current Accepting new patients

Locations

1546 Stacy Rd
Ste 100
Allen, TX 75002
Phone (214) 226-1538

2525 Lucas Dr
Bldg 3
Dallas, TX 75219
Phone (214) 528-7354

655 Taylor St
Fort Worth, TX 76102
Phone (817) 289-6800

4401 Martin Luther King Blvd
Houston, TX 77204
Phone (713) 743-1921

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1235656547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 DIVISION ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451523",
            "telephone_number": "503-656-4221",
            "fax_number": "503-656-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12050 SE STEVENS RD STE 100",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970867667",
            "telephone_number": "503-656-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAZIO",
        "first_name": "DOMINIC",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-28",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC7054",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "AT4480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Happy Valley, OR

Sources for this page

Verify at the official NPI Registry.