NPIMap

Organization Active NPI

Macadam Eye Care, P.C.

Doing business as Macadam Vision Clinic

  • Optometrist
  • Portland, OR
National Provider Identifier
1558811778
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3134AT Issued in OR
Legal business name
MACADAM EYE CARE, P.C.
Doing business as
Macadam Vision Clinic
Practice address
5901 SW Macadam Ave Ste 105
Portland, OR 97239-3620
Phone
(503) 222-2990
NPI assigned
Oct 12, 2016
Last updated
Oct 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Authorized official

Name
Dr. Mersedeh Safari Snider, O.D.NPI 1194895169
Title
President / Owner
Phone
(971) 645-8173

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
Optometrist 152W00000X 3134AT OR Primary

Addresses

Primary practice location

5901 SW Macadam Ave Ste 105
Portland, OR 97239-3620

Mailing address

5901 SW Macadam Ave Ste 105
Portland, OR 97239-3620
Phone (503) 222-2990

Other names 1

  • Macadam Vision Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170201001636 OR Part B Supplier - Clinic/Group Practice 0749563559 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

5901 S Macadam Ave
Ste 105
Portland, OR 97239
Phone (503) 222-2990

Practitioners & affiliated clinicians

Practitioners 3

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": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1558811778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 SW MACADAM AVE STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393620",
            "telephone_number": "503-222-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 SW MACADAM AVE STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393620",
            "telephone_number": "503-222-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACADAM EYE CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "SAFARI SNIDER",
        "authorized_official_first_name": "MERSEDEH",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "971-645-8173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3134AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Macadam Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.