Individual provider Active NPI

Isabel Leeds Groth, OD

  • Optometrist
  • Lake Oswego, OR
National Provider Identifier
1992699540
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4816 Issued in OR
Practice address
9 Monroe Pkwy Ste 160
Lake Oswego, OR 97035-8863
Phone
(503) 636-2551
Fax
(503) 636-3055
NPI assigned
Jun 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4816 OR Primary

Addresses

Primary practice location

9 Monroe Pkwy Ste 160
Lake Oswego, OR 97035-8863

Mailing address

9 Monroe Pkwy Ste 160
Lake Oswego, OR 97035-8863
Phone (503) 636-2551

Other practice location 1

15298 SW Royalty Pkwy
Tigard, OR 97224-3904
Phone (503) 227-2020

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
I20260622003893 OR Practitioner - Optometry 7719450774

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11086 SE Oak St
Portland, OR 97222-6692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD.OD.70014977WAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1992699540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MONROE PKWY STE 160",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358863",
            "telephone_number": "503-636-2551",
            "fax_number": "503-636-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MONROE PKWY STE 160",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358863",
            "telephone_number": "503-636-2551",
            "fax_number": "503-636-3055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15298 SW Royalty Pkwy",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972243904",
            "country_code": "US",
            "telephone_number": "503-227-2020",
            "fax_number": "503-598-9661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROTH",
        "first_name": "ISABEL",
        "middle_name": "LEEDS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-06",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.