NPIMap

Organization Active NPI

Eye Health Northwest P.C.

  • Ophthalmology Physician
  • Portland, OR
National Provider Identifier
1992397426
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE HEALTH NORTHWEST P.C.
Practice address
5935 SE Division St
Portland, OR 97206-1470
Phone
(503) 777-5546
NPI assigned
Feb 5, 2021
Last updated
Dec 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Authorized official

Name
Brett M Williams
Title
Ceo
Phone
(503) 558-7372

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

5935 SE Division St
Portland, OR 97206-1470

Mailing address

PO Box 22009
Milwaukie, OR 97269-2009
Phone (503) 558-7372

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251024003844 OR DME Supplier - Physician - OptometristDME Supplier - Physician - Ophthalmology 9234039926 Practice locations: Portland, OR

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eye Health Northwest, PC5935 SE Division St, Portland, OR 97206-1470(503) 777-5546 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Eye Health Northwestpc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

18345 SW Alexander St
Ste D
Aloha, OR 97003
Phone (503) 649-0474

18345 SW Alexander St
Ste A
Beaverton, OR 97003
Phone (503) 642-2505

12050 SE Stevens Rd
Ste 100
Happy Valley, OR 97086
Phone (503) 656-4221

5050 NE Hoyt St
Ste 245
Portland, OR 97213
Phone (503) 255-2291

9555 SW Barnes Rd
Ste 201
Portland, OR 97225
Phone (503) 227-2020

Ownership & related parties

Subparts reporting this organization as parent 18

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 18

Practitioners & affiliated clinicians

Practitioners 77

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 77

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1992397426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22009",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972692009",
            "telephone_number": "503-558-7372",
            "fax_number": "503-344-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5935 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972061470",
            "telephone_number": "503-777-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE HEALTH NORTHWEST P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-558-7372"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.