Individual provider Active NPI

Christina N. Leitzel, BS BCO BADO

  • Ocularist
  • Portland, OR
National Provider Identifier
1689199317
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OcularistTaxonomy code 156FX1700X
Practice address
2456 NW Northrup St Ste 1a
Portland, OR 97210-3253
Phone
(503) 229-8490
Fax
(503) 224-0740
NPI assigned
Aug 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X
Ocularist 156FX1700X OR Primary

Addresses

Primary practice location

2456 NW Northrup St Ste 1a
Portland, OR 97210-3253

Mailing address

2456 NW Northrup St Ste 1a
Portland, OR 97210-3253
Phone (503) 229-8490

Other identifiers 3

IdentifierTypeStateIssuer
01621900001OtherORREGENCE
7760590001OtherORMEDICARE
500647964OtherOROMAP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Ocular Prosthetics LLC Ocularist CurrentSince Oct 1, 2019 Accepting new patients

Locations

2456 NW Northrup St
Ste 1A
Portland, OR 97210
Phone (503) 222-1224

2525 NW Lovejoy St
Ste 306
Portland, OR 97210
Phone (503) 229-8490

Organizations & group practices 1

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": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1689199317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 NW NORTHRUP ST STE 1A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103253",
            "telephone_number": "503-229-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 NW NORTHRUP ST STE 1A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103253",
            "telephone_number": "503-229-8490",
            "fax_number": "503-224-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITZEL",
        "first_name": "CHRISTINA",
        "middle_name": "N.",
        "credential": "BS BCO BADO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "01621900001",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "7760590001",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "500647964",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.