Individual provider Active NPI

Carla Avruskin, O.D.

  • Optometrist
  • Tigard, OR
National Provider Identifier
1427184746
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2564ATI Issued in OR
Practice address
9730 SW Washington Square Rd
Tigard, OR 97223-4453
Phone
(503) 624-0666
Fax
(503) 624-0959
NPI assigned
Feb 23, 2007
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2564ATI OR Primary

Addresses

Primary practice location

9730 SW Washington Square Rd
Tigard, OR 97223-4453

Mailing address

9730 SW Washington Square Rd
Tigard, OR 97223

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
I20091029000531 OR Practitioner - Optometry 6608913215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogata Eyecare PCGroup PAC ID 2466351606, 6 clinicians

Practice addresses (Care Compare)

1248 Lloyd Ctr
Portland, OR 97232-1301
Phone (803) 281-1115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2564ORMDClinical Social Worker
2564ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ogata Eyecare, PC Optometrist Current Accepting new patients

Locations

1248 Lloyd Ctr
Portland, OR 97232
Phone (503) 281-1115

9730 SW Washington Square Rd
Tigard, OR 97223
Phone (503) 624-0666

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1427184746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9730 SW WASHINGTON SQUARE RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 SW WASHINGTON SQUARE RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972234453",
            "telephone_number": "503-624-0666",
            "fax_number": "503-624-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVRUSKIN",
        "first_name": "CARLA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2564ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.