Active NPI
Deepa Rao, O.D.
- Optometrist
- Portland, OR
National Provider Identifier
1740324433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2576T
- Practice address
- 1962 SW Broadway
Portland, OR 97201-6710 - Phone
- (503) 223-6655
- NPI assigned
- Feb 16, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 2576T | OR | Primary |
Addresses
Primary practice location
1962 SW Broadway
Portland, OR 97201-6710
Mailing address
10165 SW 148TH Ave
Beaverton, OR 97007-6172
Phone (503) 590-6055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2576T | OR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paul Stasik OD PC | Past | Accepting new patients | |
| Visualeyes Optometric, Inc | Past | Accepting new patients | |
| Broadway Vision World | Optometrist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Optometrist
- Portland, OR
- NPI 1295915700
-
- Corneal and Contact Management Optometrist
- Portland, OR
- NPI 1396750717
-
- Eyewear Supplier
- Portland, OR
- NPI 1588941256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740324433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10165 SW 148TH AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970076172",
"telephone_number": "503-590-6055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1962 SW BROADWAY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972016710",
"telephone_number": "503-223-6655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAO",
"first_name": "DEEPA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "2576T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.