Levi Richardson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ATI4634 Issued in OR

Practice address

2804 19TH Ave
Forest Grove, OR 97116-2625

Phone

(503) 357-2020

Fax

(503) 357-6995

NPI assigned

Jun 11, 2022

Last updated

Jun 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

Specialty

Optometry

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Richardson Eyecare PC

  • Optometrist
  • Forest Grove, OR
  • NPI 1780305797
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1932839180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 19TH AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162625",
            "telephone_number": "503-357-2020",
            "fax_number": "503-357-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 19TH AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162625",
            "telephone_number": "503-357-2020",
            "fax_number": "503-357-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "LEVI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-11",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger Reynolds, D.O.
• Richardson Eyecare PC
• Brad C Richardson, O.D.
• Eli Richardson, O.D.
• Jessica Richardson, AU.D.
• Theresa Marie Richters, QMHP,LCSW
• Patricia Loraine Rieger, PTA
• Jesus Rio-Calderon, PTA
• Emma Ristau
• Rki Primary Care at Home

• Optometrist in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; 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.