NPIMap

Organization Active NPI

Eye Health Northwest P.C.

  • Ophthalmology Physician
  • Oregon City, OR
National Provider Identifier
1871827535
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE HEALTH NORTHWEST P.C.
Practice address
1306 Division St
Oregon City, OR 97045-1523
Phone
(503) 656-4221
Fax
(503) 656-4249
NPI assigned
Sep 29, 2009
Last updated
Dec 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
EYE HEALTH NORTHWEST P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Authorized official

Name
Brett M Williams
Title
Ceo
Phone
(503) 344-5101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

1306 Division St
Oregon City, OR 97045-1523

Mailing address

11086 SE Oak St
Milwaukie, OR 97222-6692
Phone (503) 557-2020

Other identifiers 1

IdentifierTypeStateIssuer
085006MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930061410 OR DME Supplier - Physician - General Practice 9234039926 Practice locations: Oregon City, OR

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

National Provider Directory

National Provider Directory
Tax ID family
Plaza Optical19 organizations share this tax ID, including this one
Part of
Plaza Optical

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1871827535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11086 SE OAK ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226692",
            "telephone_number": "503-557-2020",
            "fax_number": "503-344-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 DIVISION ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451523",
            "telephone_number": "503-656-4221",
            "fax_number": "503-656-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE HEALTH NORTHWEST P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE HEALTH NORTHWEST P.C.",
        "enumeration_date": "2009-09-29",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-344-5101"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085006",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.