Individual provider Active NPI

Mauricio Renan Chavez, M.D.

  • Ophthalmology Physician
  • Vancouver, WA
National Provider Identifier
1598824906
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
125-046325 Issued in IL
Practice address
3200 Main St
Vancouver, WA 98663-2753
Phone
(360) 823-2012
Fax
(360) 823-2260
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 125-046325 IL Primary

Addresses

Primary practice location

3200 Main St
Vancouver, WA 98663-2753

Mailing address

3200 Main St
Vancouver, WA 98663-2753
Phone (360) 823-2012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131212001847 WA Practitioner - Ophthalmology 3779678297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Illinois Medical College, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vancouver Eye Care PSGroup PAC ID 5799673364, 10 clinicians

Practice addresses (Care Compare)

17720 SE Mill Plain Blvd
Suite 100
Vancouver, WA 98683-7584
Phone (360) 823-2020

Merit-based Incentive Payment System (MIPS)

Final score
90.47 of 100Reported as group
Quality
100
Promoting interoperability
89
Improvement activities
40
Cost
77.41

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125-046325ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vancouver Eye Care PS Ophthalmology CurrentSince Dec 1, 2013 Accepting new patients
Vancouver Eye Care, P.S. CurrentSince Dec 1, 2013 Accepting new patients
Rocky Mountain Eye Center Inc a Colorado Provider Network Ophthalmology PastSince Oct 4, 2016 Accepting new patients

Locations

2415 NE 134th St
Ste 101
Vancouver, WA 98686
Phone (360) 823-2000

3200 Main St
Vancouver, WA 98663
Phone (360) 696-4691

17720 SE Mill Plain Blvd
Ste 100
Vancouver, WA 98683
Phone (360) 823-2018

Interoperability endpoints

  • Direct secure messaging: mauricio.chavez.p1@direct.vecmaxwellit.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1598824906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MAIN ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632753",
            "telephone_number": "360-823-2012",
            "fax_number": "360-823-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MAIN ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632753",
            "telephone_number": "360-823-2012",
            "fax_number": "360-823-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "MAURICIO",
        "middle_name": "RENAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "125-046325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.