Individual provider Active NPI

Rosemary F Detmer Stone, O.D.

  • Vision Therapy Optometrist
  • Beaverton, OR
National Provider Identifier
1801871223
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
2568AT Issued in OR
Practice address
4655 SW Griffith Dr
#165
Beaverton, OR 97005-8728
Phone
(503) 646-8592
Fax
(503) 526-3989
NPI assigned
Dec 8, 2005
Last updated
Jan 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 2568AT OR Primary

Addresses

Primary practice location

4655 SW Griffith Dr
#165
Beaverton, OR 97005-8728

Mailing address

4655 SW Griffith Dr
#165
Beaverton, OR 97005-8728
Phone (503) 646-8592

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090506000366 OR Practitioner - Optometry 6406746882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A New Vision PCGroup PAC ID 0749339000, 4 clinicians

Practice addresses (Care Compare)

4655 SW Griffith Dr
Suite 165
Beaverton, OR 97005-8731
Phone (503) 646-8592

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2568ATORMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
A New Vision, P.C. Vision Therapy CurrentSince Apr 10, 2009 Accepting new patients
Rosemary F Detmer Stone OD PastSince Jan 10, 2001 Accepting new patients

Locations

4655 SW Griffith Dr
Ste 165
Beaverton, OR 97005
Phone (503) 646-8592

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.

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1801871223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 SW GRIFFITH DR",
            "address_2": "#165",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970058728",
            "telephone_number": "503-646-8592",
            "fax_number": "503-526-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 SW GRIFFITH DR",
            "address_2": "#165",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970058728",
            "telephone_number": "503-646-8592",
            "fax_number": "503-526-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETMER STONE",
        "first_name": "ROSEMARY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "OR",
            "license": "2568AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.