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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MEDICAL CENTER EYE CLINIC LLC
NPI 1255859799
Ophthalmology in Salem, OR

Active since September 05, 2017CLIA 38D2103020 · Waiver
655 MEDICAL CENTER DR NE, SALEM, OR 97301(503) 581-5287(503) 588-6843 Get Directions Write a Review

NPPES record last updated: July 15, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 15, 2026, Jul 21, 2022 (2 updates tracked since 2022).

About Medical Center Eye Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDICAL CENTER EYE CLINIC LLC (NPI 1255859799) is a healthcare organization registered as an ophthalmology in Salem, Oregon and active in the NPI registry since September 2017. The organization holds a CLIA Waiver certificate valid through October 4, 2027 and lists Shellea Montgomery, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1255859799
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameMEDICAL CENTER EYE CLINIC LLC
Location Address655 MEDICAL CENTER DR NESalem, OR 97301-2751
Mailing Address655 Medical Center Dr NeSalem, OR 97301-2751 · (503) 581-5287 · Fax (503) 386-1377
Phone(503) 581-5287
Fax(503) 588-6843
Organization SubpartNo
Authorized OfficialShellea MontgomeryPractice Administrator · (503) 581-5287
Enumeration DateSeptember 5, 2017
Last NPPES UpdateJuly 15, 20262 updates tracked since enumeration
NPPES CertifiedJuly 15, 2026
✔ NPI 1255859799 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
655 MEDICAL CENTER DR NE, Salem, OR 97301
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, BridgeSpan Health Company, Moda Health Plan, Inc. and more.Insurance ›

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 38D2103020

Medical Center Eye Clinic, LLC · Salem, OR
Active · expires Oct 4, 2027
CLIA Number38D2103020
Laboratory TypePhysician Office
Certificate Effective DateOctober 5, 2025
Certificate Expiration DateOctober 4, 2027
Laboratory DirectorMarcus A. East
Laboratory Phone(503) 581-5287
Laboratory LocationMedical Center Eye Clinic, LLC655 Medical Center Drive, NE, Salem, OR 97301
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 3

Medicare supplier enrollment and the product categories Medical Center Eye Clinic LLC carries, from the Medicare DMEPOS supplier directory.

Medical Center Eye Clinic LLC

DMEPOS supplier · Salem, OR
✔

Accepts Medicare assignment

Medical Center Eye Clinic LLC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20459927
Medicare Participant SinceOctober 1, 2017
Supplier Location655 Medical Center Dr NESalem, OR 97301
Phone(503) 581-5287
Provider TypePhysician – Ophthalmology
Supplier Specialties
Optometrist

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Prosthetic Lenses: Prosthetics Cataract Lenses
Cataract Eyeglasses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RYAN W LAPOUR MD
Ophthalmology
655 MEDICAL CENTER DR NE
SALEM, OR 97301
Marion County (503) 581-5287
DR. ADAM T SHUPE O.D.
Optometrist
655 MEDICAL CENTER DR NE
SALEM, OR 97301
Marion County (503) 581-5287
MARCUS ALLAN EAST MD
Ophthalmology
655 MEDICAL CENTER DR NE
SALEM, OR 97301
Marion County (503) 581-5287
JOHN G DODD DO
Ophthalmology
655 MEDICAL CENTER DR NE
SALEM, OR 97301
Marion County (503) 581-5287
DR. DONALD HUBBARD II MD
Ophthalmology
655 MEDICAL CENTER DR NE
SALEM, OR 97301
Marion County (503) 581-5287
DR. ROBERT EARL TIBOLT MD
Ophthalmology
655 MEDICAL CENTER DR NE
SALEM, OR 97301
Marion County (503) 581-5287
DR. ELMER THEODORE SORNSON JR. MD
Ophthalmology
655 MEDICAL CENTER DR NE
SALEM, OR 97301
Marion County (503) 581-5287
DR. THOMAS R STEVENS MD
Ophthalmology
655 MEDICAL CENTER DR NE
SALEM, OR 97301
Marion County (503) 581-5287

Frequently 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 Medical Center Eye Clinic LLC's NPI number?

The NPI number for Medical Center Eye Clinic LLC is 1255859799. It was assigned to this organization in the NPPES registry on September 5, 2017.

Where is Medical Center Eye Clinic LLC located?

Medical Center Eye Clinic LLC is located at 655 Medical Center Dr NE, Salem, OR 97301. The listed phone number is (503) 581-5287.

What is Medical Center Eye Clinic LLC's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Does Medical Center Eye Clinic LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Medical Center Eye Clinic LLC accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Medical Center Eye Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2103020) is associated with this NPI, valid through October 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Medical Center Eye Clinic LLC accept?

Health plans from BlueCross BlueShield of Tennessee, BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Medical Center Eye Clinic LLC 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 Medical Center Eye Clinic LLC was last updated on July 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 39 days 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.