Individual provider Active NPI

Paul Lau, OD

  • Optometrist
  • Beaverton, OR
National Provider Identifier
1629450796
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4609 Issued in OR
Practice address
3205 SW Cedar Hills Blvd Ste 9
Beaverton, OR 97005-1347
Phone
(971) 348-3178
Fax
(503) 350-3944
NPI assigned
Jun 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3028 OK
Optometrist 152W00000X 8737T TX
Optometrist 152W00000X 4609 OR Primary

Addresses

Primary practice location

3205 SW Cedar Hills Blvd Ste 9
Beaverton, OR 97005-1347

Mailing address

8150 SW Barnes Rd Apt J208
Portland, OR 97225-6379
Phone (510) 612-4966

Other identifiers 1

IdentifierTypeStateIssuer
00E63GOtherTXMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK, OR3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20150803000288 TX Practitioner - Optometry 3577877711 Reassigns benefits to 2 organizations
I20190924003323 OK Practitioner - Optometry 3577877711 Reassigns benefits to 1 organization
I20220510001294 OR Practitioner - Optometry 3577877711 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4609ORMDOptometrist
8737TTXMDOptometrist
3028OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of the Incarnate Word Optometrist CurrentSince Oct 1, 2015 Accepting new patients
Anthony T. Pham, O.D., P.C. Optometrist CurrentSince Jul 15, 2020 Accepting new patients
Nancy El-Hitamy Amir, CurrentSince Aug 19, 2016 Accepting new patients
Pacific Eye Group, PC Optometrist CurrentSince Feb 28, 2022 Accepting new patients
Paul Lau, OD and Maggie Man Ki Ho, OD, Ms, Faao, LLC Optometrist Current Accepting new patients
University of the Incarnate Word CurrentSince Oct 1, 2015 Accepting new patients
Newview Oklahoma Inc. Optometrist Past Accepting new patients

Locations

3360 N Ave
Bldg 685
Tinker AFB, OK 73145
Phone (405) 455-2587

3205 SW Cedar Hills Blvd
Ste 9
Beaverton, OR 97005
Phone (503) 643-4840

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

970 NW Eastman Pkwy
Gresham, OR 97030
Phone (503) 666-7460

9725 Datapoint Dr
San Antonio, TX 78229
Phone (210) 283-6800

9577 Huebner Rd
Ste 4
San Antonio, TX 78240
Phone (210) 228-0030

9725 Datapoint Dr
#69
San Antonio, TX 78229
Phone (210) 283-6800

Organizations & group practices 7

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": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1629450796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 SW BARNES RD APT J208",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256379",
            "telephone_number": "510-612-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 SW CEDAR HILLS BLVD STE 9",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051347",
            "telephone_number": "971-348-3178",
            "fax_number": "503-350-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "PAUL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-24",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3028",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8737T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00E63G",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.