Individual provider Active NPI

Marybeth Roboca-Vu

  • Optometrist
  • Battle Ground, WA
National Provider Identifier
1649832304
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60969191 Issued in OR
Practice address
101 NW 12TH Ave Ste 101
Battle Ground, WA 98604-9145
Phone
(360) 687-0755
NPI assigned
Jul 2, 2019
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60969191 OR Primary

Addresses

Primary practice location

101 NW 12TH Ave Ste 101
Battle Ground, WA 98604-9145

Mailing address

101 NW 12TH Ave Ste 101
Battle Ground, WA 98604-9145

Other names 1

  • Marybeth Roboca Former name

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
I20201223002172 OR Practitioner - Optometry 9830427418 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Murray Scholls Optique IncGroup PAC ID 1658357967, 3 clinicians
West Linn Vision Center IncGroup PAC ID 7315227634, 3 clinicians
Tigard Vision Center, Inc.Group PAC ID 1355339300, 4 clinicians

Practice addresses (Care Compare)

14600 SW Murray Scholls
Suite 104
Beaverton, OR 97007-9712
Phone (503) 579-6695

2020 8TH Ave
Suite a
West Linn, OR 97068-4657
Phone (503) 652-1479

9169 Southwest Burnham
Tigard, OR 97223-6105
Phone (503) 639-5115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60969191ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
West Linn Vision Center Inc Optometrist CurrentSince Dec 18, 2020 Accepting new patients
Myoptic Optometry, LLC CurrentSince May 1, 2023 Accepting new patients
Murray Scholls Optique Inc Optometrist CurrentSince Dec 18, 2020 Accepting new patients
Tigard Vision Center, Inc. Optometrist CurrentSince Dec 18, 2020 Accepting new patients
Spec'D Out Eye Care, PS Optometrist CurrentSince Mar 11, 2025 Accepting new patients

Locations

14600 SW Murray Scholls Dr
Ste 104
Beaverton, OR 97007
Phone (503) 579-6695

3978 N Williams Ave
Portland, OR 97227
Phone (503) 493-7070

9169 SW Burnham St
Tigard, OR 97223
Phone (503) 539-5115

2020 8th Ave
West Linn, OR 97068
Phone (503) 652-1479

2020 8th Ave
Ste A
West Linn, OR 97068
Phone (503) 303-5591

101 NW 12th Ave
Ste 101
Battle Ground, WA 98604
Phone (360) 687-0755

Interoperability endpoints

  • Direct secure messaging: marybeth.vu@direct.revolutionehr.com

Organizations & group practices 5

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1649832304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NW 12TH AVE STE 101",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NW 12TH AVE STE 101",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049145",
            "telephone_number": "360-687-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBOCA-VU",
        "first_name": "MARYBETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "60969191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYBETH",
            "last_name": "ROBOCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Battle Ground, WA

Sources for this page

Verify at the official NPI Registry.