Siskiyou Eye Center, Medical Group, PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

209930-10 Issued in OR

Legal business name

SISKIYOU EYE CENTER, MEDICAL GROUP, PC

Doing business as

Siskiyou Eye Center

Practice address

648 N Main St
Ashland, OR 97520-1710

Phone

(541) 482-8100

Fax

(541) 488-5081

NPI assigned

Jun 9, 2005

Last updated

Sep 27, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Belmira Pardal Borg

Title

Administrator

Phone

(541) 482-8100

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Siskiyou Eye Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 6

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.

• David Steven England, OD

  • Optometrist
  • Ashland, OR
  • NPI 1942205448
  Medicare reassignment Care Compare group NPD
• William Stuart Epstein, MD

  • Ophthalmology Physician
  • Ashland, OR
  • NPI 1740285667
  Medicare reassignment Care Compare group NPD
• Robert Henry Ewing Jr., MD

  • Ophthalmology Physician
  • Ashland, OR
  • NPI 1548265267
  Medicare reassignment Care Compare group NPD
• Jared Scott Fredrickson, MD

  • Ophthalmology Physician
  • Ashland, OR
  • NPI 1902394893
  Medicare reassignment Care Compare group NPD
• Jeffrey David Welder, M.D.

  • Ophthalmology Physician
  • Ashland, OR
  • NPI 1043504681
  Medicare reassignment Care Compare group NPD
• Amy J Walport, O.D.

  • Optometrist
  • Mira Loma, CA
  • NPI 1831408186

  OR

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1275537987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 N MAIN ST",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201710",
            "telephone_number": "541-482-8100",
            "fax_number": "541-488-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 N MAIN ST",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201710",
            "telephone_number": "541-482-8100",
            "fax_number": "541-488-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISKIYOU EYE CENTER, MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "BORG",
        "authorized_official_first_name": "BELMIRA",
        "authorized_official_middle_name": "PARDAL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "541-482-8100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "209930-10",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298084",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053574",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "289751",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Siskiyou Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael James Siegl, PT
• Ginger Nicole Sigala-Matcham
• Larry Silverman, CDAC
• Siskiyou Anesthesia LLC
• Siskiyou Chiropractic, LLC
• Siskiyou Imaging,LLC
• Siskiyou Massage, LLC
• Siskiyou Optical
• Siskiyou Pediatric Therapies, LLC
• Suzanne E Sky, L.AC., MTOM

• Ophthalmology Physician in Ashland, OR
• Providers in Ashland, OR by specialty
• Ophthalmology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; 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.