Individual provider Active NPI

Paul M. Stasik, O.D.

  • Optometrist
  • Portland, OR
National Provider Identifier
1841222064
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2936 Issued in OR
Practice address
19500 SE Stark St
Portland, OR 97233-5792
Phone
(800) 813-2000
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2936 OR Primary
Optometrist 152W00000X OD60913741 WA
Corneal and Contact Management Optometrist 152WC0802X 2936 OR

Addresses

Primary practice location

19500 SE Stark St
Portland, OR 97233-5792

Mailing address

500 NE Multnomah St Ste 100
Portland, OR 97232-2031
Phone (800) 813-2000

Other practice location 1

11750 SW Barnes Rd
Suite 120
Portland, OR 97225-5911
Phone (503) 646-5194

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
I20061113000400 OR Practitioner - Optometry 5890793640 Reassigns benefits to 1 organization
I20251226001108 WA Practitioner - Optometry 5890793640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

14406 NE 20TH Ave
Vancouver, WA 98686-1448
Phone (800) 813-2000

4855 SW Western Ave
Beaverton, OR 97005-3460
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2936ORMDCounselor
OD60913741WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 12, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 17, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 17, 2018 Accepting new patients

Locations

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

19500 SE Stark St
Portland, OR 97233
Phone (503) 669-3900

500 NE Multnomah St
Ste 100
Portland, OR 97232
Phone (503) 499-5200

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

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

14406 NE 20th Ave
Vancouver, WA 98686
Phone (360) 418-6001

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1841222064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322031",
            "telephone_number": "800-813-2000",
            "fax_number": "855-524-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335792",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11750 SW Barnes Rd",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972255911",
            "country_code": "US",
            "telephone_number": "503-646-5194",
            "fax_number": "503-646-9390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STASIK",
        "first_name": "PAUL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2936",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60913741",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OR",
            "license": "2936",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.