Individual provider Active NPI

Brandon Harr

  • Optometrist
  • North Bend, OR
National Provider Identifier
1457904963
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AT4508 Issued in OR
Practice address
3585 Broadway Ave
North Bend, OR 97459-1251
Phone
(541) 756-2584
NPI assigned
Jul 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AT4508 OR Primary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X ODP-100480 ID

Addresses

Primary practice location

3585 Broadway Ave
North Bend, OR 97459-1251

Mailing address

3585 Broadway Ave
North Bend, OR 97459-1251
Phone (541) 756-2584

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
I20200615000423 OR Practitioner - Optometry 5890023444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Eye Clinic PCGroup PAC ID 0446249437, 4 clinicians

Practice addresses (Care Compare)

3585 Broadway Ave
North Bend, OR 97459-1251
Phone (541) 756-2587

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
92.51
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT4508ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Optical Laboratory Corp. Single Specialty Current Accepting new patients
Bay Eye Clinic P.C. Single Specialty CurrentSince Aug 1, 2020 Accepting new patients

Locations

3585 Broadway Ave
North Bend, OR 97459
Phone (541) 756-2584

Interoperability endpoints

  • Direct secure messaging: brandon.harr@direct.revolutionehr.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1457904963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 BROADWAY AVE",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591251",
            "telephone_number": "541-756-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 BROADWAY AVE",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591251",
            "telephone_number": "541-756-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARR",
        "first_name": "BRANDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-23",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "AT4508",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100480",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, OR

Sources for this page

Verify at the official NPI Registry.