Kevie Kawasaki, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ATI4462 Issued in OR

Practice address

14740 NW Cornell Rd Ste 110
Portland, OR 97229-5400

Phone

(503) 645-8002

NPI assigned

Jun 10, 2019

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

Electronic endpoints 1

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Oswego Vision Clinic LLCGroup PAC ID 8628052362, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkawasaki8266@willowcreekeyecare.emadirect.md

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.

• Lake Oswego Vision Clinic LLC

  • Optometrist
  • Lake Oswego, OR
  • NPI 1750506937
  Medicare reassignment Care Compare group
• Central Oregon Eyecare, PC

  • Optometrist
  • Redmond, OR
  • NPI 1073715157
  Medicare reassignment NPD
• Tigard Vision Center, Inc.

  • Optometrist
  • Tigard, OR
  • NPI 1821083635
  Medicare reassignment NPD
• Central Oregon Eyecare, PC

  • Optometrist
  • Bend, OR
  • NPI 1912389511
  NPD
• Coos Eye Centers, Inc.

  • Optometrist
  • Bandon, OR
  • NPI 1518158500
  NPD (past)
• Willow Creek Eye Care Inc.

  • Corneal and Contact Management Optometrist
  • Portland, OR
  • NPI 1598000903
  NPD (past)

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1740849199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 956",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974110956",
            "telephone_number": "541-347-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14740 NW CORNELL RD STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295400",
            "telephone_number": "503-645-8002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 2nd St SE",
            "address_purpose": "LOCATION",
            "city": "Bandon",
            "state": "OR",
            "postal_code": "974119605",
            "country_code": "US",
            "telephone_number": "541-347-3622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15480 Boones Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Oswego",
            "state": "OR",
            "postal_code": "970353429",
            "country_code": "US",
            "telephone_number": "503-635-1458",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2155 NW Shevlin Park Rd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977037101",
            "country_code": "US",
            "telephone_number": "541-647-2760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 SW Indian Ave",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977563039",
            "country_code": "US",
            "telephone_number": "541-548-2488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "198 NE Combs Flat Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Prineville",
            "state": "OR",
            "postal_code": "977542563",
            "country_code": "US",
            "telephone_number": "541-447-5133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "65 NE Oak St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Madras",
            "state": "OR",
            "postal_code": "977411814",
            "country_code": "US",
            "telephone_number": "541-548-2488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 N Arrowleaf Trl Ste 103",
            "address_purpose": "LOCATION",
            "city": "Sisters",
            "state": "OR",
            "postal_code": "977592610",
            "country_code": "US",
            "telephone_number": "541-549-2105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAWASAKI",
        "first_name": "KEVIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KKawasaki8266@willowcreekeyecare.emadirect.md",
            "affiliation": "Y",
            "affiliationName": "Central Oregon Eyecare, PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 SW Indian Ave",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977563039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Margaret Kaveny, M.S.W.
• Taylor Kavkewitz
• Kristen Reiko Kawachi, DPT
• Satoshi Kawaguchi, M. D
• Violet Kawano
• Jolene Ann Kawecki, QMHA
• Amy Kay, OTR
• Bethany Kosmowski Kay, LMT
• Jacquelynne M. Kay, L.M.T.
• Jenna E Kay, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.