Active NPI
Jeffrey Charles Lind, O.D.
- Optometrist
- Hillsboro, OR
National Provider Identifier
1508867433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1491 AT
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105163 | Medicaid | OR |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1491 AT | OR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Performance of Oregon LLC | Optometrist | Current | 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.
-
- Optometrist
- Hillsboro, OR
- NPI 1548946742
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.