Individual provider Active NPI

Clara Miluska Castillejo Becerra, MD

  • Ophthalmology Physician
  • Medford, OR
National Provider Identifier
1770112476
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD219074 Issued in OR
Practice address
1408 E Barnett Rd
Medford, OR 97504-8279
Phone
(541) 779-2020
Fax
(541) 770-6838
NPI assigned
Apr 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 69555 MN
Internal Medicine Physician 207R00000X 30751 MN
Ophthalmology Physician 207W00000X MD219074 OR Primary

Addresses

Primary practice location

1408 E Barnett Rd
Medford, OR 97504-8279

Mailing address

1408 E Barnett Rd
Medford, OR 97504-8279
Phone (541) 779-2020

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621000985 OR Practitioner - Ophthalmology 9032533500 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Ohio State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cataract and Laser Institute of Southern Oregon PCGroup PAC ID 7517952344, 5 clinicians

Practice addresses (Care Compare)

1408 E Barnett Rd
Medford, OR 97504-8279
Phone (541) 779-2020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30751MNMDInternal Medicine Physician
MD219074ORMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Surgery Center CurrentSince Jun 21, 2024 Accepting new patients
Cataract and Laser Institute of Southern Oregon PC Ophthalmology CurrentSince Jun 21, 2024 Accepting new patients

Locations

2925 Siskiyou Blvd
Medford, OR 97504
Phone (541) 773-1435

1408 E Barnett Rd
Medford, OR 97504
Phone (503) 779-2464

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1770112476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048279",
            "telephone_number": "541-779-2020",
            "fax_number": "541-770-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048279",
            "telephone_number": "541-779-2020",
            "fax_number": "541-770-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLEJO BECERRA",
        "first_name": "CLARA",
        "middle_name": "MILUSKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-04",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "69555",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "30751",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD219074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.