Individual provider Active NPI

Rachel Grace Horrocks, O.D.

  • Optometrist
  • Lake Oswego, OR
National Provider Identifier
1245483452
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3266ATI Issued in OR
Practice address
15480 Boones Ferry Rd
Lake Oswego, OR 97035-3429
Phone
(503) 708-8032
NPI assigned
Oct 31, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3266ATI OR Primary

Addresses

Primary practice location

15480 Boones Ferry Rd
Lake Oswego, OR 97035-3429

Mailing address

15480 Boones Ferry Rd
Lake Oswego, OR 97035-3429
Phone (503) 708-8032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090105000179 OR Practitioner - Optometry 6901968775 Reassigns benefits to 1 organization
I20161011001400 WA Practitioner - Optometry 6901968775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evergreen Eye Care LLCGroup PAC ID 0244314961, 3 clinicians

Practice addresses (Care Compare)

1319 NE 134TH St
Suite 107
Vancouver, WA 98685-2718
Phone (360) 573-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3266ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Eye Care, LLC Optometrist CurrentSince Oct 1, 2016 Accepting new patients

Locations

13317 NE 12th Ave
Ste 107
Vancouver, WA 98685
Phone (360) 350-4794

1319 NE 134th St
Ste 107
Vancouver, WA 98685
Phone (360) 566-4700

Organizations & group practices 2

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": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1245483452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15480 BOONES FERRY RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353429",
            "telephone_number": "503-708-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15480 BOONES FERRY RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353429",
            "telephone_number": "503-708-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORROCKS",
        "first_name": "RACHEL",
        "middle_name": "GRACE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3266ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.