Individual provider Active NPI

Ronald Ray Guiley, O.D., M.P.H.

  • Optometrist
  • Bend, OR
National Provider Identifier
1619913944
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1537ATI Issued in OR
Practice address
63455 N Hwy 97 Ste 75
Bend, OR 97703-6761
Phone
(541) 388-7906
Fax
(541) 388-8190
NPI assigned
Jun 22, 2006
Last updated
Feb 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1537ATI OR Primary

Addresses

Primary practice location

63455 N Hwy 97 Ste 75
Bend, OR 97703-6761

Mailing address

63455 N Hwy 97 Ste 75
Bend, OR 97703-6761
Phone (541) 388-7906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20070705000638 OR Practitioner - Optometry 1456451426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1981
Medicare assignment
May accept Medicare assignment
Group practices
Aeg Oregon Professional LLCGroup PAC ID 5092156364, 11 clinicians
Coffman Vision Clinic IncGroup PAC ID 8123012903, 2 clinicians

Practice addresses (Care Compare)

61535 S Hwy 97
Suite 16
Bend, OR 97702-2156
Phone (541) 389-2971

61535 S Hwy 97 16
Bend, OR 97702-2156
Phone (541) 389-4774

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1537ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Coffman Vision Clinic Inc Optometrist CurrentSince Jan 1, 2017 Accepting new patients
Patrick Ayres, OD, PC Optometrist Past Accepting new patients

Locations

61535 S Highway 97
Ste 16
Bend, OR 97702
Phone (541) 389-4774

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1619913944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63455 N HWY 97 STE 75",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977036761",
            "telephone_number": "541-388-7906",
            "fax_number": "541-388-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63455 N HWY 97 STE 75",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977036761",
            "telephone_number": "541-388-7906",
            "fax_number": "541-388-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILEY",
        "first_name": "RONALD",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "O.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1537ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.