Gresham Vision Center, Inc
NPI 1619022076ActiveOrganization· Optometrist· Gresham, OR
Optometrist in Gresham, Oregon, registered in NPPES in January 2007, part of R104410. The authorized official on file is Diane Gardner, Office Manager. Enrolled in Medicare as dme supplier - physician - optometrist and part b supplier - clinic/group practice.
Overview
| NPI | 1619022076 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | R104410 |
| NPI issued | Jan 24, 2007 |
| Last updated in NPPES | Mar 19, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Optometrist (OR); Part B Supplier - Clinic/Group Practice (OR) |
|---|
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