Analicia Nicole Czupryk, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3445ATI Issued in OR

Practice address

9730 SW Washington Square Rd
Tigard, OR 97223-4453

Phone

(503) 624-0666

Fax

(503) 624-0959

NPI assigned

Jun 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

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 and National Provider Directory roles.

• Heritage Eyecare

  • Optometrist
  • Albany, OR
  • NPI 1760894356
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1710248638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7591 SW PINE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238715",
            "telephone_number": "503-701-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 SW WASHINGTON SQUARE RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972234453",
            "telephone_number": "503-624-0666",
            "fax_number": "503-624-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZUPRYK",
        "first_name": "ANALICIA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3445ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynne G. Curtis, R.PH.
• Mary Ann Custer, FNP
• Jeffrey S Cutter
• Cutting Edge Histology Services LLC
• Cynthia Gulick, PC (Southwest Family Physicians)
• Stephanie Nicole D'Andrea, AGPCNP
• Emily D'Anna
• Christine Da Rosa
• Afton Lee Daebney
• Laura L Dahl, MD

• Optometrist in Tigard, OR
• Providers in Tigard, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.