Individual provider Active NPI

Jessica Vo, OD

  • Optometrist
  • Portland, OR
National Provider Identifier
1295410215
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ATI4681 Issued in OR
Practice address
15320 NW Central Dr Ste D8
Portland, OR 97229-0990
Phone
(503) 430-0386
NPI assigned
Jun 19, 2023
Last updated
Jun 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ATI4681 OR Primary

Addresses

Primary practice location

15320 NW Central Dr Ste D8
Portland, OR 97229-0990

Mailing address

10194 NW Priscilla CT
Portland, OR 97229-5272

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
I20230801004749 OR Practitioner - Optometry 6305207705 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ATI4681ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Eye Group, PC Optometrist CurrentSince Aug 7, 2023 Accepting new patients
Cornell Eyecare Group, Inc Optometrist CurrentSince Jun 25, 2023 Accepting new patients
South Waterfront Eye Care Inc. Optometrist PastSince Oct 8, 2016 Accepting new patients
Dr. Paul M. Wehner & Associates, PC Optometrist PastSince Jun 25, 2023 Accepting new patients

Locations

63455 N Highway 97
Ste 75
Bend, OR 97703
Phone (541) 388-7906

970 NW Eastman Pkwy
Gresham, OR 97030
Phone (503) 666-7460

15320 NW Central Dr
Ste D8
Portland, OR 97229
Phone (503) 430-0386

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1295410215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10194 NW PRISCILLA CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15320 NW CENTRAL DR STE D8",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972290990",
            "telephone_number": "503-430-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VO",
        "first_name": "JESSICA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.