Cedar Hills Vision Source – Optometrist, NPI 1700833209

Cedar Hills Vision Source is a healthcare provider. based in Portland, Oregon. specializing in Optometrist. The NPI Number for Cedar Hills Vision Source is 1700833209

Main info

Organization
Name
Cedar Hills Vision Source
NPI
1700833209
Phone
(503) 292-5221
Address
1517 SW MARLOW AVE
Authorized Official
DR. KIRK J PARKER PRESIDENT O.D.
Enumeration Date
28 May 2006
Last Update Date
30 May 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness80
Years active:20State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Cedar Hills Vision Source

  • Cedar Hills Vision Clinic, 1517, Southwest Marlow Avenue, West Haven, Portland, Metro, Washington County, Oregon, 97225, United States

    PORTLAND, OR 972255101

    Phone: (503) 292-5221

    Fax: (503) 297-3937

    Mailing address matches the actual address.

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: 2006-12-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-07-31 (316 days ago).

Enrollment records

1

Earliest due date

2025-07-31

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
O20061214000399OClinic/Group PracticeOR2025-07-31

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 97225)

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Reviews

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Frequently asked questions

Is Cedar Hills Vision Source listed with a National Provider Identifier?
Yes — Cedar Hills Vision Source has NPI 1700833209 on file in the registry.
Is there an active status for Cedar Hills Vision Source?
For scheduling context, Cedar Hills Vision Source is shown as active in the registry.
How would a patient describe Cedar Hills Vision Source's focus?
For Cedar Hills Vision Source, the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Where in Oregon is Cedar Hills Vision Source registered?
Use Portland, Oregon as the headline location for Cedar Hills Vision Source here.
Can I trust this NPI listing for Cedar Hills Vision Source?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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