Active NPI
Dina H Erickson, O.D.
- Optometrist
- Forest Grove, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4000ATI
- Practice address
- Pacific University College of Optometry
2043 College Way
Forest Grove, OR 97116 - Phone
- (503) 352-3007
- Fax
- (503) 352-2929
- NPI assigned
- Aug 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4000ATI | OR | Primary |
| Optometrist | 152W00000X | 10327T | CA |
Addresses
Primary practice location
Pacific University College of Optometry
2043 College Way
Forest Grove, OR 97116
Mailing address
Pacific University College of Optometry
2043 College Way
Forest Grove, OR 97116
Phone (503) 352-3007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208312 | Medicaid | OR |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2043 College Way
Forest Grove, OR 97116-1756
Phone (503) 352-2756
222 SE 8TH Ave
Hillsboro, OR 97123-4218
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10327T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific University | Optometrist | Current | Accepting new patients |
| Pacific University | Optometrist | Current | Accepting new patients |
| Pacific University | Current | Accepting new patients | |
| Pacific University | Optometrist | Past | Accepting new patients |
| Pacific University | Optometrist | Past | Accepting new patients |
Locations
2043 College Way
Forest Grove, OR 97116
Phone (503) 352-2020
222 SE 8th Ave
#212
Hillsboro, OR 97123
Phone 5033522400 ext. 8060
222 SE 8th Ave
Ste 114
Hillsboro, OR 97123
Phone (503) 352-7300
1411 SW Morrison St
Ste 310
Portland, OR 97205
3653 SE 34th Ave
Portland, OR 97202
Phone (503) 988-3506
511 SW 10th Ave
Ste 500
Portland, OR 97205
Phone (503) 224-2323
5329 NE Mlk Jr Blvd
Portland, OR 97211
Phone (503) 988-3821
Interoperability endpoints
- derickson315783@direct.ochin.org
Organizations & group practices 5
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.
-
- Optometrist
- Hillsboro, OR
- NPI 1306954011
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- Optometrist
- Portland, OR
- NPI 1497863104
-
dba Pacific Psychology & Comprehensive Health Clinic
- Adult Mental Health Clinic/Center
- Portland, OR
- NPI 1912377193
-
- Optometrist
- Cornelius, OR
- NPI 1124225842
-
- Optometrist
- Beaverton, OR
- NPI 1124319009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457460255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY",
"address_2": "2043 COLLEGE WAY",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "97116",
"telephone_number": "503-352-3007",
"fax_number": "503-352-2929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY",
"address_2": "2043 COLLEGE WAY",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "97116",
"telephone_number": "503-352-3007",
"fax_number": "503-352-2929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "DINA",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "4000ATI",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "10327T",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208312",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Forest Grove, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.