Individual provider Active NPI

Kelsey Bertrie Evans, O.D.

  • Optometrist
  • Eugene, OR
National Provider Identifier
1891145900
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3665ATI Issued in OR
Practice address
2828 Chad Dr
Eugene, OR 97408-7336
Phone
(541) 242-0789
Fax
(541) 242-0787
NPI assigned
Jun 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3665ATI OR Primary

Addresses

Primary practice location

2828 Chad Dr
Eugene, OR 97408-7336

Mailing address

2828 Chad Dr
Eugene, OR 97408-7336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240911002857 OR Practitioner - Optometry 7911447438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott L. Nehring OD PCGroup PAC ID 6709842438, 4 clinicians

Practice addresses (Care Compare)

590 Glatt Cir
Woodburn, OR 97071-9675
Phone (503) 982-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3665ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott L. Nehring, O.D., P.C. Optometrist CurrentSince Jul 28, 2024 Accepting new patients

Locations

590 Glatt Cir
Woodburn, OR 97071
Phone (503) 982-3937

Organizations & group practices 1

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1891145900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 CHAD DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 CHAD DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087336",
            "telephone_number": "541-242-0789",
            "fax_number": "541-242-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KELSEY",
        "middle_name": "BERTRIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3665ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.