Active NPI
Kellyn Nacke Bellsmith, M.D.
- Pediatric Ophthalmology and Strabismus Specialist Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Ophthalmology and Strabismus Specialist Physician
- License
- MD198586
- Practice address
- 3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011 - Phone
- (503) 494-3000
- Fax
- (503) 494-4286
- NPI assigned
- May 11, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD198586 | OR | |
| Pediatric Ophthalmology and Strabismus Specialist Physician | 207WX0110X | MD198586 | OR | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Mailing address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-3000
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200529001407 | OR | Practitioner - Ophthalmology | 5092006130 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- University of Missouri, Columbia School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University Professional Services
Practice addresses (Care Compare)
15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311
Hospital & facility affiliations
- Ohsu Hospital and Clinics
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.11 of 100
- Quality
- 84.29
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD198586 | OR | MD | Pediatric Ophthalmology and Strabismus Specialist Physician Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Past | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
3375 SW Terwilliger Blvd
Portland, OR 97239
Phone (503) 226-3916
Interoperability endpoints
- ksmith101613@direct.ohsu.edu
Organizations & group practices 4
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.
-
- Pharmacy
- Beaverton, OR
- NPI 1073054714
-
- Clinic/Center
- Vancouver, WA
- NPI 1881848307
-
- Pediatrics Physician
- Medford, OR
- NPI 1225282122
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": "1462924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680220800000",
"number": "1801242573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-3000",
"fax_number": "503-494-4286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393011",
"telephone_number": "503-494-3000",
"fax_number": "503-494-4286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLSMITH",
"first_name": "KELLYN",
"middle_name": "NACKE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-11",
"last_updated": "2023-03-31",
"certification_date": "2023-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OR",
"license": "MD198586",
"primary": false
},
{
"code": "207WX0110X",
"taxonomy_group": "",
"desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
"state": "OR",
"license": "MD198586",
"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 Mar 31, 2023; 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.