ALEXA NICOLE I THAVORN (OD) – Optometrist, NPI 1083205074
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
672 OPTOMETRY in OR
Provider Addresses for ALEXA NICOLE I THAVORN (OD)
2621 NE 7TH AVE APT 404
PORTLAND, OR 972123179
Phone: (714) 478-2676
Type: Mailing
11805 NW CEDAR FALLS DR STE 105
PORTLAND, OR 972292780
Phone: (503) 747-0265
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $672.
Total Amount is formed as General ($672) + Research ($0) + Ownership ($0) = $672.
Last reported payment date: 2024-06-21 • Largest payer in this snapshot: CooperVision Inc. ($389).
Total Amount
$672
General + Research + Ownership
Payments
21
Total payment records
General Amount
$672
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CooperVision Inc. | $389 |
| Alcon Vision LLC | $240 |
| Johnson & Johnson Vision Care, Inc. | $29 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-03-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210325001199 | I | Optometry | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97212)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | OR | |
| O P T O M E T R Y | OR | |
| O P T O M E T R Y | OR | |
| O P T O M E T R Y | OR |
Reviews
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