NPIMap

Organization Active NPI

Darrell E Genstler MD PC

  • Eyewear Supplier
  • Albany, OR
National Provider Identifier
1700982006
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
DARRELL E GENSTLER MD PC
Practice address
2700 14TH Ave SE
Albany, OR 97322
Phone
(541) 928-1667
Fax
(541) 928-1817
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Darrell Genstler, MDNPI 1063523751
Title
Owner
Phone
(541) 928-1667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

2700 14TH Ave SE
Albany, OR 97322

Mailing address

2700 14TH Ave SE
Albany, OR 97322
Phone (541) 928-1667

Other names 1

  • The EyeWear Pavilion Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930045199 OR DME Supplier - Physician - Ophthalmology 3870499163 Practice locations: Albany, OR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Genstler Eye Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700982006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 14TH AVE SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "97322",
            "telephone_number": "541-928-1667",
            "fax_number": "541-928-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 14TH AVE SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "97322",
            "telephone_number": "541-928-1667",
            "fax_number": "541-928-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARRELL E GENSTLER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GENSTLER",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-928-1667",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The EyeWear Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.