DR. SANDRA J. MIYAMOTO O.D.
NPI 1760524268
Optometrist in Lake Oswego, OR

Q: What is Sandra Miyamoto's NPI number?

The NPI number for Sandra Miyamoto is 1760524268. It was assigned to this individual provider in the NPPES registry on February 12, 2007.

Q: What is Sandra Miyamoto's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Sandra Miyamoto was last updated on April 20, 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.

Active since February 12, 2007PECOS Enrolled

4859 MEADOWS RD STE 155, LAKE OSWEGO, OR 97035(503) 342-6853(503) 342-6185 Get Directions Write a Review

NPPES record last updated: April 20, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 30, 2021, Sep 13, 2017 (2 updates tracked since 2017).

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About Dr. Sandra J. Miyamoto O.d. NPPES

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

DR. SANDRA J. MIYAMOTO O.D. (NPI 1760524268) is an individual optometrist in Lake Oswego, Oregon, licensed in Oregon (AT4601) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1760524268

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameDR. SANDRA J. MIYAMOTOCredential: O.D.

Location Address4859 MEADOWS RD STE 155Lake Oswego, OR 97035-2628

Mailing Address4859 Meadows Rd, Ste 155Lake Oswego, OR 97035-2628 · (503) 342-6853

Phone(503) 342-6853

Fax(503) 342-6185

Sole ProprietorYes

Medical School CMSOtherGraduated 2006

Enumeration DateFebruary 12, 2007

Last NPPES UpdateApril 20, 20232 updates tracked since enumeration

NPPES CertifiedApril 20, 2023

✔ NPI 1760524268 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Licenses✔ Licensed in OR · AT4601✔ Licensed in NY · 007047✔ Licensed in CA · 13422

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.

4859 MEADOWS RD STE 155, Lake Oswego, OR 97035

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Sandra J. Miyamoto O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4880790724

PECOS Enrollment IDI20211006000560

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.

Medicare Billing Reassignment

Medicare enrollment records show Sandra Miyamoto reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Polsinelli Optometry PC

Same address

Optometrist

4859 MEADOWS RD STE 155
Lake Oswego, OR 97035

Reassigned Medicare billing, Oregon enrollment
2 clinicians in this Medicare group

NPI 1811294291 (415) 800-7763

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 97035 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 2

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

DR. ELIO POLSINELLI JR. O.D.

Optometrist

4859 MEADOWS RD STE 155
LAKE OSWEGO, OR 97035

Clackamas County (415) 800-7763

POLSINELLI OPTOMETRY PC

Optometrist

4859 MEADOWS RD STE 155
LAKE OSWEGO, OR 97035

Clackamas County (415) 800-7763

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 Sandra Miyamoto's NPI number?

The NPI number for Sandra Miyamoto is 1760524268. It was assigned to this individual provider in the NPPES registry on February 12, 2007.

Where is Sandra Miyamoto located?

Sandra Miyamoto practices at 4859 Meadows Rd Ste 155, Lake Oswego, OR 97035. The listed phone number is (503) 342-6853.

What is Sandra Miyamoto's specialty?

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

Is Sandra Miyamoto enrolled in Medicare?

Yes. Sandra Miyamoto is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sandra Miyamoto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sandra Miyamoto reassigns Medicare benefits to Polsinelli Optometry PC (Lake Oswego, 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 Sandra Miyamoto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sandra Miyamoto accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BridgeSpan Health Company and 4 other insurers list Sandra Miyamoto 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 Sandra Miyamoto was last updated on April 20, 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.