Individual provider Active NPI

Sagina O'Halloran, O.D.

  • Optometrist
  • Portland, OR
National Provider Identifier
1386979466
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3395ATI Issued in OR
Practice address
3978 N Williams Ave
Portland, OR 97227-1445
Phone
(503) 944-5475
NPI assigned
Oct 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3395ATI OR Primary

Addresses

Primary practice location

3978 N Williams Ave
Portland, OR 97227-1445

Mailing address

1046 NW Johnson St
Portland, OR 97209-3024

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
I20120418000215 OR Practitioner - Optometry 7719148741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectacle LLCGroup PAC ID 7214250844, 4 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3395ORMDClinical Psychologist
3395ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spectacle LLC Optometrist CurrentSince Jun 15, 2020 Accepting new patients
Spectacle LLC Optometrist CurrentSince Jun 15, 2020 Accepting new patients
Pacific University Optometrist Current Accepting new patients
Reed Eyecare, PC Optometrist PastSince Dec 29, 2024 Accepting new patients

Locations

2905 SW Cedar Hills Blvd
Ste 100
Beaverton, OR 97005
Phone (503) 719-5179

2043 College Way
Forest Grove, OR 97116
Phone (503) 352-2020

222 SE 8th Ave
Ste 114
Hillsboro, OR 97123
Phone (503) 352-7300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1386979466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 NW JOHNSON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3978 N WILLIAMS AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271445",
            "telephone_number": "503-944-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HALLORAN",
        "first_name": "SAGINA",
        "name_prefix": "Miss",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3395ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.