Jonathan Dale Berry, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ATI3122 Issued in OR

Practice address

2330 Heritage Way SE
Albany, OR 97322-8600

Phone

(541) 926-6077

Fax

(541) 926-0605

NPI assigned

Mar 17, 2006

Last updated

Mar 7, 2023By 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 1

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Albany Eye Care Center P CGroup PAC ID 6901895804, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Albany Eye Care Center P C

  • Optometrist
  • Albany, OR
  • NPI 1689898694
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1427027754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 HERITAGE WAY SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973228600",
            "telephone_number": "541-926-6077",
            "fax_number": "541-926-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 HERITAGE WAY SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973228600",
            "telephone_number": "541-926-6077",
            "fax_number": "541-926-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JONATHAN",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2023-03-07",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI3122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270040",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BC BS",
            "identifier": "009446008",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacque Benton
• Geoffrey A Berg, DMD
• Amber Berger
• Brianna Rose Bermudez-Shields
• Elliana Marie Berry
• Merle Nye Berry, OD
• Paul Bert, CADC II
• Carey Bertram, NP
• Better Pain Solutions LLC (South Albany Chiropractic Clinic)
• Karla Rheann Betts, RN

• Optometrist in Albany, OR
• Providers in Albany, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.