Individual provider Active NPI

Marc Landon Schmitt, O.D.

  • Optometrist
  • Portland, OR
National Provider Identifier
1669791695
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3369ATI Issued in OR
Practice address
2250 NW Lovejoy St
Portland, OR 97210-3020
Phone
(503) 719-5179
Fax
(971) 302-6934
NPI assigned
Jun 1, 2010
Last updated
Sep 9, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3369ATI OR Primary

Addresses

Primary practice location

2250 NW Lovejoy St
Portland, OR 97210-3020

Mailing address

2250 NW Lovejoy St
Portland, OR 97210-3020
Phone (503) 719-5179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, UT2 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
I20110525000354 OR Practitioner - Optometry 9032395165 Reassigns benefits to 1 organization
I20200917002063 UT Practitioner - Optometry 9032395165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectacle LLCGroup PAC ID 7214250844, 4 clinicians

Practice addresses (Care Compare)

2250 NW Lovejoy St
Portland, OR 97210-3020
Phone (503) 719-5179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectacle LLC Optometrist CurrentSince Apr 29, 2014 Accepting new patients
Spectacle LLC Optometrist CurrentSince Jul 22, 2014 Accepting new patients
Lena Barghouti-Afranji & Associates Professional Corp Optometrist PastSince Feb 15, 2011 Accepting new patients
Paul Stasik OD PC Past Accepting new patients
Cea Acquisition LLC Past Accepting new patients

Locations

2905 SW Cedar Hills Blvd
Ste 100
Beaverton, OR 97005
Phone (503) 719-5179

Organizations & group practices 6

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": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1669791695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 NW LOVEJOY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103020",
            "telephone_number": "503-719-5179",
            "fax_number": "971-302-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 NW LOVEJOY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103020",
            "telephone_number": "503-719-5179",
            "fax_number": "971-302-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITT",
        "first_name": "MARC",
        "middle_name": "LANDON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-01",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3369ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.