Individual provider Active NPI

Jennifer Magbitang, O.D.

  • Optometrist
  • Salem, OR
National Provider Identifier
1831503325
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9059427-9934 Issued in UT
Practice address
2400 Lancaster Dr NE
Salem, OR 97305-1221
Phone
(503) 361-5400
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9059427-9934 UT Primary

Addresses

Primary practice location

2400 Lancaster Dr NE
Salem, OR 97305-1221

Mailing address

18047 SW Lower Boones Ferry Rd
#314
Tigard, OR 97224-7213
Phone (510) 387-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170124002076 OR Practitioner - Optometry 3072895291 Reassigns benefits to 1 organization
I20170124003061 WA Practitioner - Optometry 3072895291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 Lancaster Dr NE
Salem, OR 97305-1221
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9059427-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 20, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 27, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 20, 2016 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

2400 Lancaster Dr NE
Ofc
Salem, OR 97305

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

7101 NE 137th Ave
Ofc
Vancouver, WA 98682
Phone (360) 944-4802

Organizations & group practices 3

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1831503325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18047 SW LOWER BOONES FERRY RD",
            "address_2": "#314",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247213",
            "telephone_number": "510-387-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051221",
            "telephone_number": "503-361-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGBITANG",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "9059427-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.