Benjamin Pon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4479 Issued in OR

Practice address

12100 SE Stevens CT
Clackamas, OR 97086-4707

Phone

(800) 813-2000

Fax

(855) 524-5255

NPI assigned

Jul 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  WA

  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1649722034
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1871848457
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

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

{
    "created_epoch": "1563580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1851944656",
    "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": "12100 SE STEVENS CT",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970864707",
            "telephone_number": "800-813-2000",
            "fax_number": "855-524-5255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30020 SW Boones Ferry Rd Ste 10",
            "address_purpose": "LOCATION",
            "city": "Wilsonville",
            "state": "OR",
            "postal_code": "970708912",
            "country_code": "US",
            "telephone_number": "503-570-0963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1006 Lloyd Ctr",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972321266",
            "country_code": "US",
            "telephone_number": "503-282-9752",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "970 NW Eastman Pkwy",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970305533",
            "country_code": "US",
            "telephone_number": "503-666-7460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PON",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-20",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Poellet, MD
• Megan A Polamalu Gordon, CHW
• Carolyn Marie Polansky, MD
• Richard Sanders Polin, MD
• Alexander Von Kantzler Polk, PHARMD
• Manuela Pop
• Corneliu G Popescu
• Andrea Marie Porter
• Susan D Porter, A.N.P.
• Positive Approaches, LLC

• Optometrist in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.