LIFETIME VISION SOURCE LLC
NPI 1710168877
Optometrist in Lebanon, OR
NPI Status: Active since November 16, 2007
Contact Information
90 MARKET ST
STE 20
LEBANON, OR
ZIP 97355
Phone: (541) 451-1144
Fax: (541) 451-1785
- Organization
- Optometrist
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 38D2076583
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-21-2028
About LIFETIME VISION SOURCE LLC
This page provides the complete NPI Profile along with additional information for Lifetime Vision Source Llc, a provider established in Lebanon, Oregon operating as a Optometrist. The healthcare provider is registered in the NPI registry with number 1710168877 assigned on November 2007. The practitioner's primary taxonomy code is 152W00000X with license number 1400ATI (OR). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's other name is Lifetime Vision Source Llc. The authorized official of this NPI record is Teresa Turrentine (Administrative Assistant)
- NPI
- 1710168877
- Provider Legal Name
- LIFETIME VISION SOURCE OF LEBANON LLC
- Other Organization Name
- LIFETIME VISION SOURCE LLC
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 90 MARKET ST STE 20 LEBANON, OR 97355
- Location Phone
- (541) 451-1144
- Location Fax
- (541) 451-1785
- Mailing Address
- 90 MARKET ST STE 20 LEBANON, OR 97355
- Mailing Phone
- (541) 451-1144
- Mailing Fax
- (541) 451-1785
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-16-2007
- Last Update Date
- 12-02-2008
- Code Navigator
Lifetime Vision Source Llc is a medicare supplier with PTAN 20649737 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Prosthetics Cataract Lenses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 1400ATI
- License State
- OR
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Bronze 8000 Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
- Bronze HSA 7000 Individual Connect - EPO
- Gold 2300 Individual Connect - EPO
- Regence Standard Bronze Plan Individual Connect - EPO
- Regence Standard Gold Plan Individual Connect - EPO
- Regence Standard Silver Plan Individual Connect - EPO
- Silver 6500 Individual Connect - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| R0000WFBYH | MEDICARE PIN (08) | OR | |
| 1211240001 | MEDICARE NSC (07) | OR | |
| 128772 | MEDICAID (05) | OR | |
| 232983 | MEDICAID (05) | OR |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20649737
- Accepts Medicare Assignment
- YES
- Specialities List
- Optometrist, Optician.
- Competitive Bidding
- NO
Supplies List
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Prosthetic Lenses: Prosthetics Cataract Lenses - Cataract Eyeglasses
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 38D2076583
- Facility Type
- Physician Office
- Certificate Effective Date
- April 22, 2026
- Certificate Expiration Date
- April 21, 2028
- Laboratory Director
- DENNIS L PEARSON OD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lifetime Vision Source Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for LIFETIME VISION SOURCE LLC
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1710168877, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710168877, enumerated as an "organization" on November 16, 2007.
The provider is located at 90 MARKET ST STE 20 LEBANON, OR 97355 and the phone number is (541) 451-1144.
Optometrist with taxonomy code 152W00000X.
The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, BridgeSpan. Please consult your insurance carrier or call the provider to verify.
