COASTAL EYECARE TILLAMOOK LLC – Medical Specialty Clinic/Center, NPI 1295210011

COASTAL EYECARE TILLAMOOK LLC is a healthcare provider. based in Seaside, Oregon. specializing in Medical Specialty Clinic/Center. The NPI Number for COASTAL EYECARE TILLAMOOK LLC is 1295210011

Main info

Organization
Name
COASTAL EYECARE TILLAMOOK LLC
NPI
1295210011
Phone
(503) 738-5361
Address
819 S HOLLADAY DR
Authorized Official
DARREN L THORSEN MEMBER
Enumeration Date
27 September 2018
Last Update Date
11 January 2019
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness75
Years active:7State licenses:0Digital endpointsOther names

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Provider Addresses for COASTAL EYECARE TILLAMOOK LLC

  • 819, South Holladay Drive, Seaside, Clatsop County, Oregon, 97138, United States

    SEASIDE, OR 971386608

    Phone: (503) 738-5361

    Type: Mailing

  • 102, Main Avenue, Tillamook, Tillamook County, Oregon, 97141, United States

    TILLAMOOK, OR 971412218

    Phone: (503) 374-0399

    Fax: (503) 374-0374

    Type: Location

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: 2019-02-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-12-31 (163 days ago).

Enrollment records

1

Earliest due date

2025-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20190212001663OClinic/Group PracticeOR2025-12-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

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 97138)

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Reviews

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Frequently asked questions

How do I look up COASTAL EYECARE TILLAMOOK LLC by NPI?
Use NPI 1295210011 when you need to reference COASTAL EYECARE TILLAMOOK LLC in forms, claims, or directories.
Is COASTAL EYECARE TILLAMOOK LLC's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is COASTAL EYECARE TILLAMOOK LLC?
The page reflects Medical Specialty Clinic/Center for COASTAL EYECARE TILLAMOOK LLC. Clinical services aligned with this taxonomy classification.
What location metadata exists for COASTAL EYECARE TILLAMOOK LLC?
The page summarizes Seaside, Oregon for COASTAL EYECARE TILLAMOOK LLC; expand the address list for detail.
How can I contact COASTAL EYECARE TILLAMOOK LLC?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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