DR. JONATHAN RUSSELL OD
NPI 1558576546
Optometrist in Clackamas, OR
About Dr. Jonathan Russell Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JONATHAN RUSSELL OD (NPI 1558576546) is an individual optometrist in Clackamas, Oregon, licensed in Oregon (2838T) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS and is a graduate of Pacific University - College Of Optometry (2001).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Jonathan Russell Od 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.
Medicare Billing Reassignment
Medicare enrollment records show Jonathan Russell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Clackamas, OR 97015
- Reassigned Medicare billing, Oregon and Washington enrollments
- Also billed through NPI 1871848457 (Washington)
- 3,207 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97086 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HAPPY VALLEY, OR 97086
PORTLAND, OR 97086
HAPPY VALLEY, OR 97086
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 Jonathan Russell's NPI number?
The NPI number for Jonathan Russell is 1558576546. It was assigned to this individual provider in the NPPES registry on May 11, 2007.
Where is Jonathan Russell located?
Jonathan Russell practices at 12100 SE Stevens Ct Suite 106, Clackamas, OR 97086. The listed phone number is (503) 353-7300.
What is Jonathan Russell's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Jonathan Russell enrolled in Medicare?
Yes. Jonathan Russell 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.
Which organization bills Medicare for Jonathan Russell's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Russell reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Northwest (Clackamas, OR). The 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 Jonathan Russell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jonathan Russell was last updated on August 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Dr. Jonathan Russell, OD · NPI 1558576546
Optometrist provider in Clackamas, Oregon. Individual provider, active in the CMS NPPES registry since May 11, 2007.
## Identity
- **NPI:** 1558576546 (Entity type: Individual)
- **Enumerated:** May 11, 2007
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 2838T (Oregon)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 12100 SE STEVENS CT, SUITE 106, Clackamas, OR 97086-4707
- **Phone:** (503) 353-7300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Kaiser Foundation Health Plan Of The Northwest (NPI 1174851505, Clackamas, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Pacific University - College Of Optometry, class of 2001
## Record status
- **NPPES last updated:** August 19, 2015
- **Other identifiers:** Medicare UPIN R153935
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Source: [NPI Profile](https://npiprofile.com/npi/1558576546) · Data from the CMS NPPES public registry.