Individual provider Active NPI

Tom Ski Thomason, OD

  • Optometrist
  • Bend, OR
National Provider Identifier
1972655264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2547T Issued in OR
Practice address
505 SW Millview Way
# 100
Bend, OR 97702-1291
Phone
(541) 317-9310
Fax
(541) 317-1202
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2547T OR Primary

Addresses

Primary practice location

505 SW Millview Way
# 100
Bend, OR 97702-1291

Mailing address

505 SW Millview Way
# 100
Bend, OR 97702-1291
Phone (541) 317-9310

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
I20050112000402 OR Practitioner - Optometry 8527016989 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2547TORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Center, LLC CurrentSince Apr 17, 2016 Accepting new patients
Eyedoc, PC Optometrist PastSince Apr 17, 2016 Accepting new patients

Locations

632 SW 6th St
Ste 3
Redmond, OR 97756
Phone (541) 923-2020

632 SW 6th St
Redmond, OR 97756
Phone (541) 923-2020

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972655264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 SW MILLVIEW WAY",
            "address_2": "# 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021291",
            "telephone_number": "541-317-9310",
            "fax_number": "541-317-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 SW MILLVIEW WAY",
            "address_2": "# 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021291",
            "telephone_number": "541-317-9310",
            "fax_number": "541-317-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASON",
        "first_name": "TOM",
        "middle_name": "SKI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2547T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.