Individual provider Active NPI

Elizabeth R. Davis, O.D.

  • Optometrist
  • Tigard, OR
National Provider Identifier
1962537258
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2592ATI Issued in OR
Practice address
9730 SW Washington Square Rd
Tigard, OR 97223-4453
Phone
(503) 624-0666
Fax
(503) 624-0959
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 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 2592ATI OR Primary

Addresses

Primary practice location

9730 SW Washington Square Rd
Tigard, OR 97223-4453

Mailing address

9730 SW Washington Square Rd
Tigard, OR 97223-4453
Phone (503) 624-0666

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
I20071023000051 OR Practitioner - Optometry 1355437336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogata Eyecare PCGroup PAC ID 2466351606, 6 clinicians

Practice addresses (Care Compare)

9730 SW Washington Square Rd
Tigard, OR 97223-4453
Phone (503) 624-0666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ogata Eyecare, PC Optometrist CurrentSince Nov 1, 2009 Accepting new patients
Pacific University Past Accepting new patients

Locations

1248 Lloyd Ctr
Portland, OR 97232
Phone (503) 281-1115

9730 SW Washington Square Rd
Tigard, OR 97223
Phone (503) 620-4850

Organizations & group practices 2

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1962537258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9730 SW WASHINGTON SQUARE RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972234453",
            "telephone_number": "503-624-0666",
            "fax_number": "503-624-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 SW WASHINGTON SQUARE RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972234453",
            "telephone_number": "503-624-0666",
            "fax_number": "503-624-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ELIZABETH",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2592ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.