RETINA NORTHWEST P.C.
NPI 1104813781
Ophthalmology in Portland, OR
About Retina Northwest P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RETINA NORTHWEST P.C. (NPI 1104813781) is a healthcare organization registered as an ophthalmology in Portland, Oregon and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through November 27, 2026, maintains 4 additional practice locations, and lists Karen L Marshall, Practice Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 4
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Retina Northwest P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date 2
Next revalidation due by February 28, 2027
This provider holds 2 Medicare enrollments with upcoming revalidation dates. Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Retina Northwest P.C., which bills Medicare for the services they deliver. Of these, 6 practice at this address and 7 within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 38D2050430
Retina Northwest, PC · Portland, ORFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Retina Northwest P.C.'s NPI number?
The NPI number for Retina Northwest P.C. is 1104813781. It was assigned to this organization in the NPPES registry on September 29, 2005.
Where is Retina Northwest P.C. located?
Retina Northwest P.C. is located at 5440 SW Westgate Dr Ste 217, Portland, OR 97221. The listed phone number is (503) 274-2121.
What is Retina Northwest P.C.'s specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Retina Northwest P.C. enrolled in Medicare?
Yes. Retina Northwest P.C. is registered in the Medicare PECOS enrollment system.
When is Retina Northwest P.C.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), Retina Northwest P.C. holds 2 Medicare enrollments with upcoming revalidation dates. The next is due by February 28, 2027 (Non-DME Part B, Oregon, Clinic/Group Practice). Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Retina Northwest P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians, all in Ophthalmology, reassign their Medicare billing to Retina Northwest P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 6 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Retina Northwest P.C. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 38D2050430) is associated with this NPI, valid through November 27, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Retina Northwest P.C. accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Retina Northwest P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Retina Northwest P.C. was last updated on May 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Retina Northwest P.c. · NPI 1104813781
Ophthalmology organization in Portland, Oregon. Organization record, active in the CMS NPPES registry since September 29, 2005.
## Identity
- **NPI:** 1104813781 (Entity type: Organization)
- **Enumerated:** September 29, 2005
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **Organization subpart:** No
- **Authorized official:** Karen Marshall, PRACTICE MANAGER
## Practice location
- **Address:** 5440 SW WESTGATE DR STE 217, Portland, OR 97221-2421
- **Phone:** (503) 274-2121 · **Fax:** (866) 843-7990
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Oregon, Clinic/Group Practice), next of 2 enrollments with upcoming dates · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 7 clinicians (Ophthalmology) reassign Medicare billing to this organization (form CMS-855R); 6 practice at this address and 7 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 11, 2023
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1104813781) · Data from the CMS NPPES public registry.