Mary Joyce Avisado

Primary specialty

OptometristTaxonomy code 152W00000X

License

ATI4728 Issued in OR

Practice address

2043 College Way
Forest Grove, OR 97116-1797

Phone

(503) 352-2020

NPI assigned

Mar 4, 2024

Last updated

Jun 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific UniversityGroup PAC ID 0345144705, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pacific University

  • Optometrist
  • Hillsboro, OR
  • NPI 1306954011
  Medicare reassignment Care Compare group NPD
• Pacific University

  • Adult Mental Health Clinic/Center
  • Hillsboro, OR
  • NPI 1700256989
  NPD
• Pacific University

  dba Pacific Psychology & Comprehensive Health Clinic

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1912377193
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1699532069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161797",
            "telephone_number": "503-352-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161797",
            "telephone_number": "503-352-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVISADO",
        "first_name": "MARY JOYCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4728",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OR",
            "license": "ATI4728",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Douglas Archibald, STUDENT/INTERN
• Randilyn Armstrong, RDH
• Jasmine Arrusamy
• Kerry Jones Ashby, PA
• Jonathan August
• Babbitt Chiropractic
• Douglas Eric Babbitt, D.C.
• Joseph Douglas Baker, OD CANDIDATE 2023
• Payson Baker
• Elissa Nicole Baldwin, ATC

• Optometrist in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.