Individual provider Active NPI

Brian Arthur Arvidson I, O.D

  • Optometrist
  • Chehalis, WA
National Provider Identifier
1508050337
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60119604 Issued in WA
Practice address
2517 NE Kresky Ave
Chehalis, WA 98532-2409
Phone
(360) 748-8632
Fax
(360) 748-3869
NPI assigned
Sep 5, 2007
Last updated
Nov 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ATI3220 OR
Optometrist 152W00000X ODP-100229 ID
Optometrist 152W00000X 3220 ATI OR
Optometrist 152W00000X OD60119604 WA Primary

Addresses

Primary practice location

2517 NE Kresky Ave
Chehalis, WA 98532-2409

Mailing address

PO Box 1506
Chehalis, WA 98532-0409
Phone (360) 242-3008

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.arvdison.p1@direct.pcli.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA, ID3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20071011000711 OR Practitioner - Optometry 0143316737 Reassigns benefits to 1 organization
I20110623000066 WA Practitioner - Optometry 0143316737 Reassigns benefits to 1 organization
I20111006000228 ID Practitioner - Optometry 0143316737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Cataract and Laser Institute Inc PCGroup PAC ID 7517864119, shared by 15 NPIs, 75 clinicians

Practice addresses (Care Compare)

19801 SW 72ND Ave
Suite 150
Tualatin, OR 97062-8347
Phone (503) 691-2283

2517 NE Kresky Ave
Chehalis, WA 98532-2433
Phone (360) 748-8632

2915 S Alder St
Tacoma, WA 98409-4803
Phone (253) 473-0275

3330 4TH St
Lewiston, ID 83501-4405
Phone (208) 746-2025

6695 W Rio Grande Ave
Kennewick, WA 99336-3301
Phone (509) 736-0826

9309 NE 86TH St
Vancouver, WA 98662-2100
Phone (360) 694-2544

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3220 ATIORMDOptometrist
ATI3220ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Cataract and Laser Institute, Inc., P.C. CurrentSince Aug 29, 2011 Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. Current Accepting new patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. CurrentSince Jun 20, 2011 Accepting new patients
Pacific Cataract and Laser Institute, Inc., P.C. CurrentSince Jun 20, 2011 Accepting new patients
Pacific Cataract and Laser Institute Inc PC Current Accepting new patients
Pacific University Past Accepting new patients

Locations

2822 S Vista Ave
Boise, ID 83705
Phone (208) 385-7576

3330 4th St
Lewiston, ID 83501
Phone (208) 746-2025

1331 NW Lovejoy St
Ste 750
Portland, OR 97209
Phone (503) 535-2883

19801 SW 72nd Ave
Ste 150
Tualatin, OR 97062
Phone (503) 691-2283

2606 116th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 462-7664

4330 Mitchell Way
Bellingham, WA 98226
Phone (360) 736-6860

2517 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 748-8632

6695 W Rio Grande Ave
Kennewick, WA 99336
Phone (509) 736-0826

115 New View Ct NE
Olympia, WA 98506
Phone (360) 252-1642

9598 Mickelberry Rd NW
Silverdale, WA 98383
Phone (360) 698-5062

16818 E Desmet Ct
Spokane Valley, WA 99216
Phone (360) 242-3008

2915 S Alder St
Tacoma, WA 98409
Phone (253) 473-0275

2205 NE 129th St
Vancouver, WA 98686
Phone (360) 450-6644

3900 Kern Rd
Yakima, WA 98902
Phone (509) 966-1356

Interoperability endpoints

  • Direct secure messaging: brian.arvdison.p1@direct.pcli.nextgenshare.com
  • Direct secure messaging: brian.arvidson.p1@direct.pcli.nextgenshare.com

Organizations & group practices 9

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": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1508050337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320409",
            "telephone_number": "360-242-3008",
            "fax_number": "360-807-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2517 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322409",
            "telephone_number": "360-748-8632",
            "fax_number": "360-748-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARVIDSON",
        "first_name": "BRIAN",
        "middle_name": "ARTHUR",
        "name_suffix": "I",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI3220",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100229",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3220 ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60119604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.arvdison.p1@direct.pcli.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2517 NE Kresky Ave",
            "city": "Chehalis",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985322409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

Verify at the official NPI Registry.