Individual provider Active NPI

Mark Yost

  • Optometrist
  • Tigard, OR
National Provider Identifier
1821713645
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
44277 Issued in OR
Practice address
9975 SW Frewing St Ste 130
Tigard, OR 97223-5091
Phone
(503) 906-3596
Fax
(503) 906-1014
NPI assigned
Oct 4, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 44277 OR Primary

Addresses

Primary practice location

9975 SW Frewing St Ste 130
Tigard, OR 97223-5091

Mailing address

1834 NW 25TH Ave Apt 501
Portland, OR 97210-2764
Phone (415) 407-6519

Other practice location 1

11020 SW Beaverton Hillsdale Hwy
Beaverton, OR 97005-3007
Phone (503) 526-9697

Other practice location 2

15405 SW 116th Ave Ste 204
King City, OR 97224-4101
Phone (971) 371-3927

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
I20221130003593 OR Practitioner - Optometry 5092183301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Gatti Vision LLCGroup PAC ID 7618305764, 2 clinicians

Practice addresses (Care Compare)

15405 SW 116TH Ave
Suite 204
King City, OR 97224-4101
Phone (971) 371-3927

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44277ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeport Eye Physicians, LLC Optometrist CurrentSince Oct 17, 2022 Accepting new patients
JD Harris PC Optometrist PastSince Jan 20, 2010 Accepting new patients
Tigard Vision World, P.C. Optometrist Past Accepting new patients
Broadway Vision World Optometrist Past Accepting new patients

Locations

20015 SW Pacific Hwy
Ste 150
Sherwood, OR 97140
Phone (503) 610-1025

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1821713645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 NW 25TH AVE APT 501",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102764",
            "telephone_number": "415-407-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9975 SW FREWING ST STE 130",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235091",
            "telephone_number": "503-906-3596",
            "fax_number": "503-906-1014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11020 SW Beaverton Hillsdale Hwy",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970053007",
            "country_code": "US",
            "telephone_number": "503-526-9697",
            "fax_number": "503-644-8330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15405 SW 116th Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "King City",
            "state": "OR",
            "postal_code": "972244101",
            "country_code": "US",
            "telephone_number": "971-371-3927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOST",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-04",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "44277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.