Individual provider Active NPI

Andrew Shawn Armstrong, O.D.

  • Optometrist
  • Portland, OR
National Provider Identifier
1972665586
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2978T Issued in OR
Practice address
2719 SE 21St Ave
Portland, OR 97202-2236
Phone
(503) 546-2565
Fax
(503) 546-2680
NPI assigned
Dec 14, 2006
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2978T OR Primary
Optometrist 152W00000X 3956 WA

Addresses

Primary practice location

2719 SE 21St Ave
Portland, OR 97202-2236

Mailing address

2719 SE 21St Ave
Portland, OR 97202-2236
Phone (503) 546-2565

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
I20080124000574 OR Practitioner - Optometry 2860574233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2719 SE 21St Ave
Portland, OR 97202-2236
Phone (503) 546-2565

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2978TORMDOptometrist
3956WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Blink LLC Optometrist CurrentSince Jan 1, 2007 Accepting new patients

Locations

2719 SE 21st Ave
Portland, OR 97202
Phone (503) 546-2565

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972665586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 SE 21ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022236",
            "telephone_number": "503-546-2565",
            "fax_number": "503-546-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 SE 21ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022236",
            "telephone_number": "503-546-2565",
            "fax_number": "503-546-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMSTRONG",
        "first_name": "ANDREW",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2978T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3956",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.