Active NPI
Gilbert Le Cren
- Optometrist
- Newport, OR
National Provider Identifier
1700865961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3015ATI
- Practice address
- 111 SE Douglas St
Ste D
Newport, OR 97365-4499 - Phone
- (541) 265-9458
- Fax
- (541) 265-6586
- NPI assigned
- Jan 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3015ATI | OR | Primary |
Addresses
Primary practice location
111 SE Douglas St
Ste D
Newport, OR 97365-4499
Mailing address
PO Box 1367
Newport, OR 97365-0106
Phone (541) 265-9458
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 276456 | Medicaid | OR |
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
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051214000746 | OR | Practitioner - Optometry | 3375564677 | Practice locations: Newport, OR |
| O20110512000461 | OR | DME Supplier - Physician - Optometrist | 3476739210 | Practice locations: Newport, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
111 SE Douglas St
Suite D
Newport, OR 97365-4400
Phone (541) 265-9458
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3015ATI | OR | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305244800000",
"number": "1700865961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1367",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973650106",
"telephone_number": "541-265-9458",
"fax_number": "541-265-6586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 SE DOUGLAS ST",
"address_2": "STE D",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973654499",
"telephone_number": "541-265-9458",
"fax_number": "541-265-6586"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE CREN",
"first_name": "GILBERT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-15",
"last_updated": "2011-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "3015ATI",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "276456",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newport, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; 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.