Individual provider Active NPI

Shauna Renee Schissler, O.D.

  • Optometrist
  • Portland, OR
National Provider Identifier
1245496454
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3141ATI Issued in OR
Practice address
11750 SW Barnes Rd Ste 120
Portland, OR 97225-5911
Phone
(503) 646-5194
Fax
(503) 646-9390
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3141ATI OR Primary

Addresses

Primary practice location

11750 SW Barnes Rd Ste 120
Portland, OR 97225-5911

Mailing address

11750 SW Barnes Rd Ste 120
Portland, OR 97225-5911
Phone (503) 646-5194

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
I20080819000538 OR Practitioner - Optometry 4385719723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11750 SW Barnes Rd
Suite 120
Portland, OR 97225-5911
Phone (503) 646-5194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3141ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Barnes Elite Eye Care Optometrist Current Accepting new patients
Elite Eye Care, Inc. Optometrist PastSince Jul 19, 2013 Accepting new patients

Locations

11750 SW Barnes Rd
Ste 120
Portland, OR 97225
Phone (503) 320-5697

Organizations & group practices 3

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": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1245496454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11750 SW BARNES RD STE 120",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255911",
            "telephone_number": "503-646-5194",
            "fax_number": "503-646-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 SW BARNES RD STE 120",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255911",
            "telephone_number": "503-646-5194",
            "fax_number": "503-646-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHISSLER",
        "first_name": "SHAUNA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3141ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.