Individual provider Active NPI

E. Winter Lewis, OD

  • Optometrist
  • Bend, OR
National Provider Identifier
1730110354
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2786ATI Issued in OR
Practice address
2450 NE Mary Rose PL
Suite 110
Bend, OR 97701-7132
Phone
(541) 318-8388
Fax
(541) 318-7145
NPI assigned
Jul 5, 2006
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2786ATI OR Primary

Addresses

Primary practice location

2450 NE Mary Rose PL
Suite 110
Bend, OR 97701-7132

Mailing address

2450 NE Mary Rose PL
Suite 110
Bend, OR 97701-7132
Phone (541) 318-8388

Other identifiers 1

IdentifierTypeStateIssuer
228967MedicaidOR

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070131000376 OR Practitioner - Optometry 3779584966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infocus Eye Care LLCGroup PAC ID 2365436755, 7 clinicians

Practice addresses (Care Compare)

2450 NE Mary Rose PL
Suite 110
Bend, OR 97701-7132
Phone (541) 318-8388

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2786ORMDClinical Social Worker
2786ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Infocus Eye Care LLC Optometrist CurrentSince Mar 1, 2008 Accepting new patients
Valley Eye Care P C Optometrist PastSince Sep 14, 2005 Accepting new patients
Eyeglass Factory Optometrist Past Accepting new patients
Lifetime Vision Source of Lebanon LLC Optometrist PastSince Oct 1, 1996 Accepting new patients

Locations

2450 NE Mary Rose Pl
Ste 110
Bend, OR 97701
Phone (541) 318-8388

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1730110354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL",
            "address_2": "SUITE 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017132",
            "telephone_number": "541-318-8388",
            "fax_number": "541-318-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 NE MARY ROSE PL",
            "address_2": "SUITE 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017132",
            "telephone_number": "541-318-8388",
            "fax_number": "541-318-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "E.",
        "middle_name": "WINTER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2786ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228967",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.