NPIMap

Organization Active NPI

Pacific Eye Group, PC

  • Optometrist
  • Bend, OR
National Provider Identifier
1831656925
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PACIFIC EYE GROUP, PC
Doing business as
Pacific Eye Group, PC
Practice address
63455 N Hwy 97 Ste 75
Bend, OR 97703-6761
Phone
(541) 389-5207
Fax
(541) 389-2718
NPI assigned
Feb 25, 2019
Last updated
Aug 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Authorized official

Name
Thompson Sowash, ODNPI 1023461647
Title
Owner
Phone
(303) 552-7139

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

63455 N Hwy 97 Ste 75
Bend, OR 97703-6761

Mailing address

175 E Houston St
San Antonio, TX 78205-2255
Phone (726) 444-4078

Other names 1

  • Pacific Eye Group, PC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190402001264 OR Part B Supplier - Clinic/Group Practice 1355682246 Receives reassigned benefits from 18 practitioners
Practice locations: Beaverton, OR; Tualatin, OR; Tigard, OR; Salem, OR; Portland, OR; Gresham, OR; Medford, OR; Eugene, OR…
O20200330003425 WA Part B Supplier - Clinic/Group Practice 1355682246 Receives reassigned benefits from 7 practitioners
Practice locations: Vancouver, WA

National Provider Directory

National Provider Directory
Tax ID family
Pacific Eye Group PC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

11170 NE Evergreen Pkwy
Beaverton, OR 97006
Phone (503) 617-0963

3205 SW Cedar Hills Blvd
Beaverton, OR 97005
Phone (503) 643-4840

63455 N Highway 97
Ste 75
Bend, OR 97703
Phone (541) 388-7906

265 Valley River Ctr
Eugene, OR 97401
Phone (541) 345-6988

12000 SE 82nd Ave
Ste 2193
Portland, OR 97086
Phone (503) 654-6217

799 Lancaster Dr NE
Ste 120
Salem, OR 97301
Phone (503) 364-4896

8700 NE Vancouver Mall Dr
Ste 168
Vancouver, WA 98662
Phone (360) 253-3663

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566259200000",
    "number": "1831656925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HOUSTON ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052255",
            "telephone_number": "726-444-4078",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63455 N HWY 97 STE 75",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977036761",
            "telephone_number": "541-389-5207",
            "fax_number": "541-389-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC EYE GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-08-20",
        "status": "A",
        "authorized_official_last_name": "SOWASH",
        "authorized_official_first_name": "THOMPSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-552-7139",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Eye Group, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.