ANITA (ANNIE) PHROMSIVARAK BACON O.D.
NPI 1366583684
Optometrist in Portland, OR

Q: What is Anita (annie) Bacon's NPI number?

The NPI number for Anita (annie) Bacon is 1366583684. It was assigned to this individual provider in the NPPES registry on February 9, 2007. The provider is also known as Annie Phromsivarak O.D..

Q: What is Anita (annie) Bacon's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since February 09, 2007PECOS EnrolledAccepts Medicare Assignment

921 SW 16TH AVE, PORTLAND, OR 97205(503) 227-0573 Get Directions Write a Review

NPPES record last updated: May 21, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Anita (annie) Phromsivarak Bacon O.d. NPPES

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

ANITA (ANNIE) PHROMSIVARAK BACON O.D. (NPI 1366583684) is an individual optometrist in Portland, Oregon, licensed in Oregon (3195AT) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS and is a graduate of New England College Of Optometry (2006).

NPPES Registry Identity

NPI1366583684

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameANITA (ANNIE) PHROMSIVARAK BACONCredential: O.D.

Location Address921 SW 16TH AVEPortland, OR 97205-1730

Mailing Address921 Sw 16th AvePortland, OR 97205-1730 · (503) 227-0573

Phone(503) 227-0573

Sole ProprietorNo

Medical School CMSNew England College Of OptometryGraduated 2006

Enumeration DateFebruary 9, 2007

Last NPPES UpdateMay 21, 2013

✔ NPI 1366583684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in OR · 3195AT

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

921 SW 16TH AVE, Portland, OR 97205

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Other Names 1

Other Name (5)Annie Phromsivarak O.d.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Anita (annie) Phromsivarak Bacon O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779681416

PECOS Enrollment IDI20070605000029

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

30 services27 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

29 services29 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97205 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$134.16 typical visit price

range $58.99 – $176.88

Typical copayment $33.54 (range $14.74 – $44.22)

Most-billed visit code 99204

Established Patient

$73.28 typical visit price

range $19.32 – $144.79

Typical copayment $18.32 (range $4.83 – $36.19)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

URBAN EYE GALLERY, LLC

Optometrist

921 SW 16TH AVE
PORTLAND, OR 97205

Multnomah County (503) 227-0573

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 Anita (annie) Bacon's NPI number?

The NPI number for Anita (annie) Bacon is 1366583684. It was assigned to this individual provider in the NPPES registry on February 9, 2007. The provider is also known as Annie Phromsivarak O.D..

Where is Anita (annie) Bacon located?

Anita (annie) Bacon practices at 921 SW 16th Ave, Portland, OR 97205. The listed phone number is (503) 227-0573.

What is Anita (annie) Bacon's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Anita (annie) Bacon enrolled in Medicare?

Yes. Anita (annie) Bacon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Anita (annie) Bacon accept?

Health plans from BridgeSpan Health Company, PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Anita (annie) Bacon 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 Anita (annie) Bacon was last updated on May 21, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.