Polsinelli Optometry PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

POLSINELLI OPTOMETRY PC

Practice address

4859 Meadows Rd Ste 155
Lake Oswego, OR 97035-2628

Phone

(415) 800-7763

Fax

(415) 800-7765

NPI assigned

Feb 19, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Elio Polsinelli Jr., O.D.NPI 1073694980

Title

Owner/Ceo

Phone

(503) 342-6853

Specialties & licenses 2

Addresses

Other names 1

• Polsinelli Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elio Polsinelli Jr., O.D.

  • Optometrist
  • Lake Oswego, OR
  • NPI 1073694980
  Medicare reassignment Care Compare group Authorized official
• Sandra J. Miyamoto, O.D.

  • Optometrist
  • Lake Oswego, OR
  • NPI 1760524268
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1298073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617235200000",
    "number": "1811294291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4859 MEADOWS RD STE 155",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352628",
            "fax_number": "415-800-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4859 MEADOWS RD STE 155",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352628",
            "telephone_number": "415-800-7763",
            "fax_number": "415-800-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLSINELLI OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-19",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "POLSINELLI",
        "authorized_official_first_name": "ELIO",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "503-342-6853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13359",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Polsinelli Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Petya Pohlschneider
• Point Power LLC
• Leah Grace Polenske, LPC
• Ciara Polito
• Kris Pollack, DC
• Elio Polsinelli Jr., O.D.
• Sarah Joy Poncin
• Ponderosa Health, LLC
• Myranda Pool
• Svetlana V Poroshina

• Optometrist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.