Individual provider Active NPI

Jeffrey Charles Lind, O.D.

  • Optometrist
  • Hillsboro, OR
National Provider Identifier
1508867433
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1491 AT Issued in OR
Practice address
7129 NE Imbrie Dr
Hillsboro, OR 97124
Phone
(503) 690-2020
Fax
(503) 645-0548
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1491 AT OR Primary

Addresses

Primary practice location

7129 NE Imbrie Dr
Hillsboro, OR 97124

Mailing address

7129 NE Imbrie Dr
Hillsboro, OR 97124-7594
Phone (503) 690-2020

Other practice location 1

7129 NE Imbrie Dr
Hillsboro, OR 97124-7594
Phone (503) 690-2020

Other identifiers 1

IdentifierTypeStateIssuer
105163MedicaidOR

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
I20100604000130 OR Practitioner - Optometry 8527197300 Reassigns benefits to 1 organization
Practice locations: Hillsboro, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1491 ATORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Performance of Oregon LLC Optometrist CurrentSince Oct 2, 2023 Accepting new patients

Locations

7129 NE Imbrie Dr
Hillsboro, OR 97124
Phone (503) 690-2020

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.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1508867433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7129 NE IMBRIE DR",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971247594",
            "telephone_number": "503-690-2020",
            "fax_number": "503-645-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7129 NE IMBRIE DR",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "97124",
            "telephone_number": "503-690-2020",
            "fax_number": "503-645-0548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7129 NE Imbrie Dr",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971247594",
            "country_code": "US",
            "telephone_number": "503-690-2020",
            "fax_number": "503-645-0548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIND",
        "first_name": "JEFFREY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1491 AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105163",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.