NPIMap

Organization Active NPI

University Professional Services

  • Ophthalmology Physician
  • Longview, WA
National Provider Identifier
1962656868
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
UNIVERSITY PROFESSIONAL SERVICES
Practice address
600 Triangle Ctr.
Suite 400
Longview, WA 98632-4667
Phone
(360) 423-0220
NPI assigned
Nov 5, 2008
Organization subpart
Yes
Parent organization
UNIVERSITY PROFESSIONAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Kelly Anne Smith
Title
VP/Enterprise Revenue Cycle
Phone
(503) 494-4422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

600 Triangle Ctr.
Suite 400
Longview, WA 98632-4667

Mailing address

1400 SW 5TH Ave Ste 500
Portland, OR 97201-5537
Phone (866) 617-6855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081222000088 WA Part B Supplier - Clinic/Group Practice 4880760107 Receives reassigned benefits from 47 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vancouver, WA; White Salmon, WA; Walla Walla, WA; Longview, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
University Professional Services18 organizations share this tax ID, including this one
Part of
University Professional Services

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1962656868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SW 5TH AVE STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015537",
            "telephone_number": "866-617-6855",
            "fax_number": "503-346-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 TRIANGLE CTR.",
            "address_2": "SUITE 400",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324667",
            "telephone_number": "360-423-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PROFESSIONAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY PROFESSIONAL SERVICES",
        "enumeration_date": "2008-11-05",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "VP/ENTERPRISE REVENUE CYCLE",
        "authorized_official_telephone_number": "503-494-4422"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.