NPIMap

Organization Active NPI

Hillsboro Eye Clinic, PC

  • Eyewear Supplier
  • Hillsboro, OR
National Provider Identifier
1275628869
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
HILLSBORO EYE CLINIC, PC
Practice address
18650 NW Cornell Rd
Suite 112
Hillsboro, OR 97124-9208
Phone
(503) 645-8808
Fax
(503) 693-0441
NPI assigned
Oct 3, 2006
Last updated
Jun 16, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
HILLSBORO EYE CLINIC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Authorized official

Name
Dr. Timothy L Gard, MDNPI 1659375244
Title
President
Phone
(503) 640-3708

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X OR Primary

Addresses

Primary practice location

18650 NW Cornell Rd
Suite 112
Hillsboro, OR 97124-9208

Mailing address

512 E Main St
Hillsboro, OR 97123-9208
Phone (503) 640-3708

Other names 1

  • Tanasbourne Optical Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930080949 OR DME Supplier - Physician - OphthalmologyDME Supplier - Optician 2961499348 Practice locations: Hillsboro, OR

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Hillsboro Opticians3 organizations share this tax ID, including this one
Part of
Hillsboro Opticians

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655337600000",
    "number": "1275628869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 E MAIN ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971239208",
            "telephone_number": "503-640-3708",
            "fax_number": "503-693-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18650 NW CORNELL RD",
            "address_2": "SUITE 112",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249208",
            "telephone_number": "503-645-8808",
            "fax_number": "503-693-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSBORO EYE CLINIC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HILLSBORO EYE CLINIC, PC",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A",
        "authorized_official_last_name": "GARD",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-640-3708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tanasbourne Optical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.