Individual provider Active NPI

Spencer Kevin Luke, O.D.

  • Optometrist
  • La Grande, OR
National Provider Identifier
1356638761
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3427ATI Issued in OR
Practice address
10709 S Walton Rd
La Grande, OR 97850-8490
Phone
(541) 962-7753
NPI assigned
Jul 6, 2011
Last updated
Sep 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8024988-9934 UT
Optometrist 152W00000X 3427ATI OR Primary

Addresses

Primary practice location

10709 S Walton Rd
La Grande, OR 97850-8490

Mailing address

10709 S Walton Rd
La Grande, OR 97850-8490
Phone (541) 962-7753

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
I20111007000055 OR Practitioner - Optometry 1557533965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Apple Eyecare PCGroup PAC ID 5799758959, 3 clinicians

Practice addresses (Care Compare)

10709 S Walton Rd
Island City, OR 97850-8490
Phone (541) 962-7753

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3427ATIORMDOptometrist
8024988-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Eyecare PC Optometrist CurrentSince Sep 21, 2011 Accepting new patients

Locations

10709 S Walton Rd
La Grande, OR 97850
Phone (541) 962-7753

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, 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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1356638761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10709 S WALTON RD",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978508490",
            "telephone_number": "541-962-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10709 S WALTON RD",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978508490",
            "telephone_number": "541-962-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKE",
        "first_name": "SPENCER",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "8024988-9934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3427ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.