Jamal Masalmeh, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2956ATI Issued in OR

Practice address

3303 S Bond Ave
Portland, OR 97239-4501

Phone

(503) 494-3000

Fax

(503) 418-0843

NPI assigned

Mar 19, 2007

Last updated

Jun 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kayenta Alternative Rural HospitalGroup PAC ID 3678558129, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kayenta Alternative Rural Hospital Hospital, Kayenta, AZ, CCN 030195

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kayenta Alternative Rural Hospital

  • General Acute Care Hospital
  • Kayenta, AZ
  • NPI 1174692529

  TX

  Medicare reassignment Care Compare group NPD
• Kayenta Alternative Rural Hospital

  dba Kayenta Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Kayenta, AZ
  • NPI 1285750125
  NPD
• Kayenta Alternative Rural Hospital

  dba Inscription House Health Center

  • General Acute Care Hospital
  • Tonalea, AZ
  • NPI 1740359108
  NPD
• Kayenta Alternative Rural Hospital

  dba Dennehotso Health Center

  • General Acute Care Hospital
  • Dennehotso, AZ
  • NPI 1821167297
  NPD
• Lenore's Optical

  • Optician
  • Longview, WA
  • NPI 1205054103
  NPD (past)
• Medical Vision Center, LTD

  • Optometrist
  • Morton, WA
  • NPI 1861697070
  NPD (past)
• Rosebud Indian Health Service

  • Ambulatory Surgical Clinic/Center
  • Rosebud, SD
  • NPI 1790955128
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1417071861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-3000",
            "fax_number": "503-418-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-3000",
            "fax_number": "503-418-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASALMEH",
        "first_name": "JAMAL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003972",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2956ATI",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "OD00003972",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OR",
            "license": "2956ATI",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OR",
            "license": "2956ATI",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "OR",
            "license": "2956ATI",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "OR",
            "license": "2956ATI",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "OR",
            "license": "2956ATI",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emil Tristan Marz
• Russell Bennett Marz, ND, LAC
• Sarah J Marzolf, FNP
• Giovanni Alessandro Mas
• Masada 2 Corporation, Dba: Life Recovery Treatment Center
• Ranjan Charles Victor Mascarenhas, MD
• Monique Rueda Mascarinas, SLP
• Gianfranco Mascia Betancourt, LPC
• Alex Michael Mascioli
• Joelle Mascord

• 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 Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.