NPIMap

Organization Active NPI

Summit Eyecare, LLC

Doing business as Eye to Eye Clinic

  • Optometrist
  • West Linn, OR
National Provider Identifier
1518204692
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3380-AT Issued in OR
Legal business name
SUMMIT EYECARE, LLC
Doing business as
Eye to Eye Clinic
Practice address
22400 Salamo Rd
Suite 100
West Linn, OR 97068-8269
Phone
(503) 722-7737
Fax
(503) 722-4152
NPI assigned
Jan 10, 2013
Last updated
Jan 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Authorized official

Name
Dr. Erin Anderson, O.D.
Title
Optometrist/Owner
Phone
(503) 722-7737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3380-AT OR Primary

Addresses

Primary practice location

22400 Salamo Rd
Suite 100
West Linn, OR 97068-8269

Mailing address

22400 Salamo Rd
Suite 100
West Linn, OR 97068-8269
Phone (503) 722-7737

Other names 1

  • Eye to Eye Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130510000166 OR Part B Supplier - Clinic/Group Practice 5294972246 Receives reassigned benefits from 3 practitioners
Practice locations: West Linn, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1357776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1518204692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22400 SALAMO RD",
            "address_2": "SUITE 100",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970688269",
            "telephone_number": "503-722-7737",
            "fax_number": "503-722-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22400 SALAMO RD",
            "address_2": "SUITE 100",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970688269",
            "telephone_number": "503-722-7737",
            "fax_number": "503-722-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-10",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "503-722-7737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3380-AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye to Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Linn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.