Individual provider Active NPI

Randy H Norris, O.D.

  • Optometrist
  • Ontario, OR
National Provider Identifier
1619928587
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3386ATI Issued in OR
Practice address
1257 SW 4TH Ave
Ontario, OR 97914-4516
Phone
(541) 889-2191
Fax
(541) 881-1523
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP-100098 ID
Optometrist 152W00000X 3386ATI OR Primary

Addresses

Primary practice location

1257 SW 4TH Ave
Ontario, OR 97914-4516

Mailing address

1257 SW 4TH Ave
Ontario, OR 97914-4516
Phone (541) 889-2191

Other identifiers 1

IdentifierTypeStateIssuer
807822301MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071127000087 ID Practitioner - Optometry 0244130045 Reassigns benefits to 1 organization
I20120904000462 OR Practitioner - Optometry 0244130045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eye Center PAGroup PAC ID 3173687944, 6 clinicians

Practice addresses (Care Compare)

350 E LN S
Ontario, OR 97914-3058
Phone (541) 889-2020

395 S 16TH St
Payette, ID 83661-3351
Phone (208) 642-4434

Merit-based Incentive Payment System (MIPS)

Final score
66.81 of 100Reported as group
Quality
33.62
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-100098IDMDOptometrist
3386ATIORMDOptometrist
2264MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hollingshead Eye Center, PC Optometrist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rnorris.od@familyeyecenter.eyefinity-direct.com

Organizations & group practices 2

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1619928587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 SW 4TH AVE",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979144516",
            "telephone_number": "541-889-2191",
            "fax_number": "541-881-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 SW 4TH AVE",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979144516",
            "telephone_number": "541-889-2191",
            "fax_number": "541-881-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "RANDY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100098",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3386ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807822301",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

Verify at the official NPI Registry.