Stacy Jo Hill, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3548ATI Issued in OR

Practice address

4655 SW Griffith Dr Ste 165
Beaverton, OR 97005-8731

Phone

(503) 646-8592

NPI assigned

Jun 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Stacy Jo Koster Former name

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

Illinois College of Optometry at Chicago, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

A New Vision PCGroup PAC ID 0749339000, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• A New Vision, P.C.

  • Optometrist
  • Beaverton, OR
  • NPI 1578704573
  Medicare reassignment Care Compare group NPD
• Pacific University

  • Optometrist
  • Hillsboro, OR
  • NPI 1306954011
  NPD
• Rosemary F Detmer Stone OD

  • Optometrist
  • Beaverton, OR
  • NPI 1609051259
  NPD (past)

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1457765604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 SW GRIFFITH DR STE 165",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970058731",
            "telephone_number": "503-646-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 SW GRIFFITH DR STE 165",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970058731",
            "telephone_number": "503-646-8592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2043 College Way",
            "address_purpose": "LOCATION",
            "city": "Forest Grove",
            "state": "OR",
            "postal_code": "971161797",
            "country_code": "US",
            "telephone_number": "503-352-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILL",
        "first_name": "STACY",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OR",
            "license": "3548ATI",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "OR",
            "license": "3548ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3548ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500673809",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "KOSTER",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zachary Hilgart
• Amanda Jane Hill, ABOC
• Caitlynn Hill, MS
• Christian N Hill, MD
• Douglas Hill
• Lucinda Rose Hillenbrand
• Lindsay Hilton, LMFT
• Andrea Hinojosa
• Sydney Alicia Hinze
• Sean Hiromura, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; 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.