Individual provider Active NPI

Aristomenis Thanos, M.D

  • Retina Specialist (Ophthalmology) Physician
  • Portland, OR
National Provider Identifier
1275820714
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
181543 Issued in OR
Practice address
1040 NW 22ND Ave BLDG 2
Portland, OR 97210-3057
Phone
(248) 288-2280
NPI assigned
Jul 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 181543 OR
Retina Specialist (Ophthalmology) Physician 207WX0107X 181543 OR Primary

Addresses

Primary practice location

1040 NW 22ND Ave BLDG 2
Portland, OR 97210-3057

Mailing address

1040 NW 22ND Ave BLDG 2
Portland, OR 97210-3057
Phone (503) 413-7022

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170814001809 OR Practitioner - Ophthalmology 6204070923 Reassigns benefits to 2 organizations
I20200831001913 WA Practitioner - Ophthalmology 6204070923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Good Samaritan Hospital and Medical CenterGroup PAC ID 0547179939, 190 clinicians
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

1040 NW 22ND Ave
Suite 168
Portland, OR 97210-3036
Phone (503) 413-7022

1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074

2529 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

7021 SW Nyberg St
Suite 210
Tualatin, OR 97062-6248
Phone (503) 413-8202

Hospital & facility affiliations

  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
181543ORMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Aug 1, 2017 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Aug 1, 2017 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Mar 11, 2025 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Peacehealth CurrentSince Apr 29, 2020 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Mar 11, 2025 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Peacehealth CurrentSince Apr 29, 2020 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Aug 1, 2017 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Aug 1, 2017 Accepting new patients
Pacific Imaging Associates LLC PastSince Jul 24, 2022 Accepting new patients
Alliance Physicians Inc Past Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Past Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

300 N Graham St
Ste 300
Portland, OR 97227
Phone (503) 280-3620

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

1040 NW 22nd Ave
Bldg 2
Portland, OR 97210
Phone (248) 288-2280

1040 NW 22nd Ave
Ste 168
Portland, OR 97210
Phone (503) 413-7022

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

7021 SW Nyberg St
Ste 210
Tualatin, OR 97062
Phone (503) 413-8202

2529 NE 139th St
Vancouver, WA 98686
Phone 3608822778 ext. 67386

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

2525 NE 139th St
Ste 280
Vancouver, WA 98686

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

Interoperability endpoints

  • Direct secure messaging: athanos428810@direct.peacehealth.org
  • Direct secure messaging: athanos25980@tvc-direct.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1275820714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE BLDG 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103057",
            "telephone_number": "503-413-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE BLDG 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103057",
            "telephone_number": "248-288-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANOS",
        "first_name": "ARISTOMENIS",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "181543",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "OR",
            "license": "181543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.