St Lukes Eye Clinic PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

DO07540 Issued in OR

Legal business name

ST LUKES EYE CLINIC PC

Practice address

10365 SE Sunnyside Rd
Suite 150
Clackamas, OR 97015-5741

Phone

(503) 698-2300

Fax

(503) 698-2308

NPI assigned

Jan 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jay Gordon Betts, D.O.NPI 1265518666

Title

Ophthalmologist

Phone

(503) 698-2300

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Jay Gordon Betts, D.O.

  • Ophthalmology Physician
  • Clackamas, OR
  • NPI 1265518666

  Ophthalmology

  NPD (past) Authorized official

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1730366246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10365 SE SUNNYSIDE RD",
            "address_2": "SUITE 150",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155741",
            "telephone_number": "503-698-2300",
            "fax_number": "503-698-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10365 SE SUNNYSIDE RD",
            "address_2": "SUITE 150",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155741",
            "telephone_number": "503-698-2300",
            "fax_number": "503-698-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES EYE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "BETTS",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "503-698-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "DO07540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067231",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Breanna Elizabeth Sreter
• St Lukes Eye Clinic PC
• Matthew G St. Peter, MD
• Michelle Travers Stacey, M.D.
• Makenna Stafford, RD
• Jennifer Lynn Stager, MA CCC-SLP

• All providers in Clackamas, OR
• Ophthalmology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.