Organization Active NPI

Patrick Ayres, OD, PC

Doing business as Riverbend Eyecare

  • Optometrist
  • Bend, OR
National Provider Identifier
1619152485
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3188AT Issued in OR
Legal business name
PATRICK AYRES, OD, PC
Doing business as
Riverbend Eyecare
Practice address
143 SW Shevlin Hixon Dr
Suite 101
Bend, OR 97702-3189
Phone
(541) 317-9747
Fax
(541) 317-1818
NPI assigned
Dec 29, 2007
Last updated
Mar 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Dr. Patrick Ayres, O.D.NPI 1639150873
Title
President/Ceo
Phone
(541) 317-9747

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 3188AT OR Primary

Addresses

Primary practice location

143 SW Shevlin Hixon Dr
Suite 101
Bend, OR 97702-3189

Mailing address

143 SW Shevlin Hixon Dr
Suite 101
Bend, OR 97702-3189
Phone (541) 317-9747

Other identifiers 1

IdentifierTypeStateIssuer
278946MedicaidOR

Other names 1

  • Riverbend Eyecare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080208000165 OR Part B Supplier - Clinic/Group Practice 9234212655 Receives reassigned benefits from 3 practitioners
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

143 SW Shevlin Hixon Dr
Bend, OR 97702

143 SW Shevlin Hixon Dr
Ste 101
Bend, OR 97702
Phone (541) 317-9747

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": "1198886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1619152485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 SW SHEVLIN HIXON DR",
            "address_2": "SUITE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023189",
            "telephone_number": "541-317-9747",
            "fax_number": "541-317-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 SW SHEVLIN HIXON DR",
            "address_2": "SUITE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023189",
            "telephone_number": "541-317-9747",
            "fax_number": "541-317-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK AYRES, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-29",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "AYRES",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "541-317-9747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3188AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278946",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverbend Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.