NPIMap

Organization Active NPI

Eye Health Northwest P.C.

  • Ophthalmology Physician
  • Portland, OR
National Provider Identifier
1790445633
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE HEALTH NORTHWEST P.C.
Practice address
9135 SW Barnes Rd Ste 961
Portland, OR 97225-6699
Phone
(503) 297-8243
Fax
(503) 297-8244
NPI assigned
Dec 20, 2021
Organization subpart
Yes
Parent organization
EYE HEALTH NORTHWEST P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Authorized official

Name
Brett M Williams
Title
Ceo
Phone
(503) 344-5101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

9135 SW Barnes Rd Ste 961
Portland, OR 97225-6699

Mailing address

PO Box 22009
Portland, OR 97269-2009
Phone (503) 558-7372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220419000363 OR DME Supplier - Physician - OptometristDME Supplier - Physician - Ophthalmology 9234039926 Practice locations: Portland, OR

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eye Health Northwest9135 SW Barnes Rd, Portland, OR 97225-6699(503) 297-8243 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Eye Health Northwest PC19 organizations share this tax ID, including this one
Part of
Eye Health Northwest PC

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

9135 SW Barnes Rd
Ste 961
Portland, OR 97225
Phone (503) 292-0848

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1790445633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22009",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972692009",
            "telephone_number": "503-558-7372",
            "fax_number": "503-344-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 SW BARNES RD STE 961",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256699",
            "telephone_number": "503-297-8243",
            "fax_number": "503-297-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE HEALTH NORTHWEST P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE HEALTH NORTHWEST P.C.",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-344-5101"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "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 Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.