RETINA NORTHWEST P.C. – Ophthalmology Physician, NPI 1104813781
Ophthalmology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for RETINA NORTHWEST P.C.
2525, Northwest Lovejoy Street, Northwest District, Portland, Metro, Multnomah County, Oregon, 97210, United States
SUITE 100
PORTLAND, OR 972102859
Phone:
Type: Mailing
5440 SW WESTGATE DR STE 217
PORTLAND, OR 972212421
Phone: (503) 274-2121
Fax: (866) 843-7990
Type: Location
2525 NW LOVEJOY ST STE 300
PORTLAND, OR 972102864
Phone:
Type: Mailing
9135 SW Barnes Rd Ste 661
Portland, OR 972256683
Phone: (503) 274-2121
Fax: (866) 843-7990
Type: Location
5050 NE Hoyt St Ste 421
Portland, OR 972132984
Phone: (503) 274-2121
Fax: (866) 843-7990
Type: Location
9 Monroe Pkwy Ste 150
Lake Oswego, OR 970358863
Phone: (503) 274-2121
Fax: (866) 843-7990
Type: Location
120 NE 136th Ave Ste 240
Vancouver, WA 986846951
Phone: (503) 274-2121
Fax: (866) 843-7990
Type: Location
4225 NE ST JAMES RD
VANCOUVER, WA 986632148
Phone: (503) 274-2121
Fax: (866) 843-7990
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2004-06-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| O20040130000725 | O | Clinic/Group Practice | OR | TBD |
| O20040604000976 | O | Clinic/Group Practice | WA | 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 97210)
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