NPIMap

Organization Active NPI

Pacific University

  • Optometrist
  • Portland, OR
National Provider Identifier
1497863104
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PACIFIC UNIVERSITY
Practice address
511 SW 10TH
Suite 500
Portland, OR 97205
Phone
(503) 352-2500
Fax
(503) 352-2523
NPI assigned
Aug 25, 2006
Last updated
Nov 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Alecia Neuman
Title
Director of Finance and Accounting
Phone
(503) 352-2951

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

511 SW 10TH
Suite 500
Portland, OR 97205

Mailing address

2043 College Way BLDG 2221
Forest Grove, OR 97116-1756
Phone (503) 352-2500

Other names 1

  • Pacific University EyeClinic Portland Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000350 OR Part B Supplier - Clinic/Group Practice 0345144705 Receives reassigned benefits from 50 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hillsboro, OR; Portland, OR; Forest Grove, OR; Cornelius, OR; Beaverton, OR

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

511 SW 10th Ave
Ste 500
Portland, OR 97205
Phone (503) 224-2323

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1497863104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY BLDG 2221",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161756",
            "telephone_number": "503-352-2500",
            "fax_number": "971-226-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 SW 10TH",
            "address_2": "SUITE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-352-2500",
            "fax_number": "503-352-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "NEUMAN",
        "authorized_official_first_name": "ALECIA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE AND ACCOUNTING",
        "authorized_official_telephone_number": "503-352-2951"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific University EyeClinic Portland",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.