NPIMap

Organization Active NPI

Spectacle LLC

  • Optometrist
  • Portland, OR
National Provider Identifier
1376951293
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3369ATI Issued in OR
Legal business name
SPECTACLE LLC
Practice address
2250 NW Lovejoy St
Portland, OR 97210-3020
Phone
(503) 719-5179
Fax
(971) 302-6934
NPI assigned
Jul 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Authorized official

Name
Dr. Marc Schmitt, O.D.NPI 1669791695
Title
Optometrist/Owner
Phone
(503) 719-5179

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3369ATI OR Primary

Addresses

Primary practice location

2250 NW Lovejoy St
Portland, OR 97210-3020

Mailing address

2250 NW Lovejoy St
Portland, OR 97210-3020
Phone (503) 719-5179

Other names 1

  • Spectacle Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150106001354 OR Part B Supplier - Clinic/Group Practice 7214250844 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Beaverton, OR; Portland, OR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Spectacle LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1376951293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 NW LOVEJOY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103020",
            "telephone_number": "503-719-5179",
            "fax_number": "971-302-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 NW LOVEJOY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103020",
            "telephone_number": "503-719-5179",
            "fax_number": "971-302-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTACLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "SCHMITT",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "503-719-5179",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3369ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectacle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.