CONVERGE NEURO OPTOMETRY LLC – Optometrist, NPI 1427919729

CONVERGE NEURO OPTOMETRY LLC is a healthcare provider. based in Beaverton, Oregon. specializing in Optometrist. The NPI Number for CONVERGE NEURO OPTOMETRY LLC is 1427919729

Main info

Organization
Name
CONVERGE NEURO OPTOMETRY LLC
NPI
1427919729
Phone
(650) 521-4570
Address
13010 SW CASPIAN CT
Authorized Official
MACSON LEE CEO, OD, FOVDRA O.D.
Enumeration Date
18 November 2025
Last Update Date
18 November 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness85
Years active:0State licenses:0Digital endpointsOther names

Provider Addresses for CONVERGE NEURO OPTOMETRY LLC

  • 13010 SW CASPIAN CT

    BEAVERTON, OR 970087760

    Phone: (650) 521-4570

    Type: Mailing

  • 9975 SW FREWING ST STE 130

    TIGARD, OR 972235091

    Phone: (503) 906-3596

    Fax: (503) 906-1014

    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: 2026-02-20

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20260220000284OClinic/Group PracticeORTBD

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.

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 97008)

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Reviews

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Frequently asked questions

Does CONVERGE NEURO OPTOMETRY LLC have a public NPI I can cite?
Public records show CONVERGE NEURO OPTOMETRY LLC under NPI 1427919729.
Should I treat CONVERGE NEURO OPTOMETRY LLC as an active provider?
Patients and plans typically see CONVERGE NEURO OPTOMETRY LLC as active in the national extract.
How should patients interpret CONVERGE NEURO OPTOMETRY LLC's specialty?
The extract shows Optometrist for CONVERGE NEURO OPTOMETRY LLC. Clinical services aligned with this taxonomy classification.
What geographic area is tied to CONVERGE NEURO OPTOMETRY LLC?
CONVERGE NEURO OPTOMETRY LLC is associated with Beaverton, Oregon in the same public data insurers reference.
Can I export CONVERGE NEURO OPTOMETRY LLC's record?
You can download the official NPPES record; we summarize key fields for readability.

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