Active NPI
Paul S Imperia, M.D.
- Ophthalmology Physician
- Medford, OR
National Provider Identifier
1487722179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 17163
- Practice address
- 1333 E Barnett Rd
Medford, OR 97504-8219 - Phone
- (541) 779-4711
- Fax
- (541) 779-0796
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 17163 | OR | Primary |
Addresses
Primary practice location
1333 E Barnett Rd
Medford, OR 97504-8219
Mailing address
1333 E Barnett Rd
Medford, OR 97504-8219
Phone (541) 779-4711
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180014364 | Other | RAILROAD MEDICARE | |
| 001191005 | Other | BLUE CROSS BLUE SHIELD | |
| 031026 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17163 | OR | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Eye Center Optical Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Eyewear Supplier
- Grants Pass, OR
- NPI 1629242938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294963200000",
"number": "1487722179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1333 E BARNETT RD",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048219",
"telephone_number": "541-779-4711",
"fax_number": "541-779-0796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1333 E BARNETT RD",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048219",
"telephone_number": "541-779-4711",
"fax_number": "541-779-0796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMPERIA",
"first_name": "PAUL",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2011-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OR",
"license": "17163",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180014364",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "001191005",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "031026",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.