Individual provider Active NPI

Sara Renee Williams, OD

  • Optometrist
  • Beaverton, OR
National Provider Identifier
1528009792
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3131T Issued in OR
Practice address
11020 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3007
Phone
(503) 526-9697
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3131T OR Primary
Optometrist 152W00000X OD60115145 WA
Corneal and Contact Management Optometrist 152WC0802X OD60115145 WA
Occupational Vision Optometrist 152WX0102X OD60115145 WA
Pediatric Optometrist 152WP0200X OD60115145 WA
Sports Vision Optometrist 152WS0006X OD60115145 WA
Vision Therapy Optometrist 152WV0400X OD60115145 WA

Addresses

Primary practice location

11020 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3007

Mailing address

11020 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3007
Phone (503) 526-9697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20211115001724 NY Practitioner - Optometry 9234211939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3131TORMDOptometrist
OD60115145WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Vision Center Inc Optometrist CurrentSince Aug 12, 2021 Accepting new patients
Empire Vision Center, Inc CurrentSince Aug 12, 2021 Accepting new patients
Vision Care Associates PLLC Optometrist Past Accepting new patients
Vision Care Associates PLLC Optometrist Past Accepting new patients
JD Harris PC Optometrist PastSince Jan 20, 2010 Accepting new patients
Broadway Vision World Optometrist Past Accepting new patients

Locations

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

1440 Central Ave
Ste E2
Colonie, NY 12205
Phone (518) 489-8575

9 Boices Ln
Kingston, NY 12401
Phone (845) 336-3937

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

Organizations & group practices 6

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1528009792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11020 SW BEAVERTON HILLSDALE HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053007",
            "telephone_number": "503-526-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 SW BEAVERTON HILLSDALE HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053007",
            "telephone_number": "503-526-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SARA",
        "middle_name": "RENEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3131T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60115145",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "OD60115145",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "WA",
            "license": "OD60115145",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "WA",
            "license": "OD60115145",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "WA",
            "license": "OD60115145",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "WA",
            "license": "OD60115145",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.