Bridgetown Optometric Associates LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

3608ATI Issued in OR

Legal business name

BRIDGETOWN OPTOMETRIC ASSOCIATES LLC

Practice address

12923 NW Cornell Rd Ste 203
Portland, OR 97229-5834

Phone

(503) 645-5076

NPI assigned

Aug 19, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Michael D Olma, ODNPI 1932452752

Title

Partner

Phone

(702) 540-1333

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael D Olma, O.D.

  • Optometrist
  • Beaverton, OR
  • NPI 1932452752
  Medicare reassignment Care Compare group NPD Authorized official
• Deanna Olma, OD

  • Optometrist
  • Tigard, OR
  • NPI 1295198885
  Medicare reassignment Care Compare group NPD
• Amand Stephen Tasripin, O.D.

  • Optometrist
  • Portland, OR
  • NPI 1508141656
  Medicare reassignment Care Compare group NPD
• Joan Claudine Quiba, OD

  • Optometrist
  • Kapolei, HI
  • NPI 1912498643

  OR

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1336515741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12923 NW CORNELL RD STE 203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295834",
            "telephone_number": "503-645-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12923 NW CORNELL RD STE 203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295834",
            "telephone_number": "503-645-5076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11577 SW Pacific Hwy",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972238671",
            "country_code": "US",
            "telephone_number": "503-968-5249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIDGETOWN OPTOMETRIC ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "OLMA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "702-540-1333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3608ATI",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3577ATI",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Portland, OR
• Providers in Portland, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.