Individual provider Active NPI

Bruce Franklin Breckenridge, OD

  • Optometrist
  • Portland, OR
National Provider Identifier
1346201886
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2070T Issued in OR
Practice address
13140 NE Halsey St
Portland, OR 97230-2350
Phone
(503) 253-7278
Fax
(503) 253-0279
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2070T OR Primary

Addresses

Primary practice location

13140 NE Halsey St
Portland, OR 97230-2350

Mailing address

13140 NE Halsey St
Portland, OR 97230-2350
Phone (503) 253-7278

Other identifiers 3

IdentifierTypeStateIssuer
020193MedicaidOR
300365203OtherORFIRST CHOICE 65
810438003OtherORBLUE CROSS

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
I20060224000263 OR Practitioner - Optometry 8123034386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13140 NE Halsey St
Portland, OR 97230-2350
Phone (503) 253-7278

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2070TORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Melzer & Breckenridge PC Optometrist CurrentSince Jul 31, 1989 Accepting new patients

Locations

13140 NE Halsey St
Portland, OR 97230
Phone (503) 253-7278

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1346201886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13140 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302350",
            "telephone_number": "503-253-7278",
            "fax_number": "503-253-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13140 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302350",
            "telephone_number": "503-253-7278",
            "fax_number": "503-253-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECKENRIDGE",
        "first_name": "BRUCE",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2070T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020193",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CHOICE 65",
            "identifier": "300365203",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "810438003",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.