Individual provider Active NPI

Jordan Edward Beckstead, OD

  • Student in an Organized Health Care Education/Training Program
  • Forest Grove, OR
National Provider Identifier
1487493623
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2043 College Way
Forest Grove, OR 97116-1797
Phone
(503) 352-2020
NPI assigned
May 20, 2024
Last updated
May 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

2043 College Way
Forest Grove, OR 97116-1797

Mailing address

275 E Rose St
Lebanon, OR 97355-4233
Phone (541) 740-1520

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
I20240709004724 OR Practitioner - Optometry 6002351574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River View Family Eyecare LLCGroup PAC ID 4385824374, 3 clinicians

Practice addresses (Care Compare)

609 Hickory St NW
Suite 160
Albany, OR 97321-1766
Phone (541) 967-3097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1487493623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 E ROSE ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554233",
            "telephone_number": "541-740-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161797",
            "telephone_number": "503-352-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKSTEAD",
        "first_name": "JORDAN",
        "middle_name": "EDWARD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Grove, OR

Sources for this page

Verify at the official NPI Registry.