NPIMap

Organization Active NPI

Laura M Gianelli OD & Walter R Receconi OD, PC

  • Optometrist
  • Astoria, OR
National Provider Identifier
1538376207
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2022ATI 1994ATI Issued in OR
Legal business name
LAURA M GIANELLI OD & WALTER R RECECONI OD, PC
Doing business as
North Coast Vision Center
Practice address
577 18TH St
Astoria, OR 97103-3505
Phone
(503) 325-4401
Fax
(503) 325-3278
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
Dr. Walter R. Receconi, O.D.NPI 1477682284
Title
Optometrist Co-Owner
Phone
(503) 325-4401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2022ATI 1994ATI OR Primary

Addresses

Primary practice location

577 18TH St
Astoria, OR 97103-3505

Mailing address

577 18TH St
Astoria, OR 97103-3505
Phone (503) 325-4401

Other identifiers 3

IdentifierTypeStateIssuer
1994ATIOtherORLICENSE
150738MedicaidOR
2022ATIOtherORLICENSE

Other names 1

  • North Coast Vision Center Doing business as

National Provider Directory

National Provider Directory

Locations

577 18th St
Astoria, OR 97103
Phone (503) 325-4401

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1538376207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 18TH ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033505",
            "telephone_number": "503-325-4401",
            "fax_number": "503-325-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 18TH ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033505",
            "telephone_number": "503-325-4401",
            "fax_number": "503-325-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA M GIANELLI OD & WALTER R RECECONI OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "RECECONI",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OPTOMETRIST CO-OWNER",
        "authorized_official_telephone_number": "503-325-4401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2022ATI      1994ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1994ATI",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150738",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2022ATI",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Coast Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Astoria, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.