Individual provider Active NPI

Despina Anna Velanis, OD

  • Optometrist
  • Portland, OR
National Provider Identifier
1235822883
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ATI4677 Issued in OR
Practice address
11786 SW Barnes Rd Ste 270
Portland, OR 97225-5929
Phone
(503) 747-5044
NPI assigned
May 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ATI4677 OR Primary

Addresses

Primary practice location

11786 SW Barnes Rd Ste 270
Portland, OR 97225-5929

Mailing address

11786 SW Barnes Rd Ste 270
Portland, OR 97225-5929
Phone (503) 747-5044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20230705003407 OR Practitioner - Optometry 4587023825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nelsi IncGroup PAC ID 8022374636, 2 clinicians

Practice addresses (Care Compare)

11786 SW Barnes Rd
Suite 270
Portland, OR 97225-5929
Phone (507) 319-1904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ATI4677ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nelsi Inc CurrentSince Jun 12, 2023 Accepting new patients

Locations

11786 SW Barnes Rd
Ste 270
Portland, OR 97225
Phone (503) 520-0777

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1235822883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11786 SW BARNES RD STE 270",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255929",
            "telephone_number": "503-747-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11786 SW BARNES RD STE 270",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255929",
            "telephone_number": "503-747-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELANIS",
        "first_name": "DESPINA",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.