Vitaliy Pelikhatyy (NPI# 1740515824, PAC ID# 1557517356) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1740515824 |
| PAC ID by PECOS | 1557517356 |
| Professional Enrollment ID | I20120820000614 |
| Full Name | Vitaliy Pelikhatyy |
| Organization Legal Name | PROFESSIONAL PROVIDER ENTERPRISE LLC |
| Address |
11850 Sw Allen Blvd Beaverton OR 97005-4805 |
| Phone Number | 5036467164 |
| Gender | M |
| Medical School | PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY |
| Graduation Year | 2011 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 0840458667 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 11850 Sw Allen Blvd, Beaverton, OR 97005-4805 | 5036467164 | PROFESSIONAL PROVIDER ENTERPRISE LLC |
| 19945 Sw Boones Ferry Rd, Tualatin, OR 97062-7272 | 5036125400 | PROFESSIONAL PROVIDER ENTERPRISE LLC |
| 2330 Debok Rd, West Linn, OR 97068-3902 | 5036550474 | PROFESSIONAL PROVIDER ENTERPRISE LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_012_overall | Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 86% | |
| MIPS_EC_014_overall | Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 65% | |
| MIPS_EC_117_overall | Diabetes: Eye Exam | 91% | |
| MIPS_EC_140_overall | Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 91% |
| Organization Legal Name | PROFESSIONAL PROVIDER ENTERPRISE LLC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cory James Jensen | Optometry | Professional Provider Enterprise LLC | 135 S 336th St, Federal Way, WA 98003-6350 |
| Shannon Seymour | Optometry | Professional Provider Enterprise LLC | 1475 Se 100th Ave, Portland, OR 97216-2537 |
| Lyndon Graves | Optometry | Professional Provider Enterprise LLC | 2730 Crow Creek Rd, Bettendorf, IA 52722-2066 |
| Sarah Paige Henderson | Optometry | Professional Provider Enterprise LLC | 135 S 336th St, Federal Way, WA 98003-6350 |
| Street Address |
11850 SW ALLEN BLVD |
| City | BEAVERTON |
| State | OR |
| Zip | 97005-4805 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Monica S Froman-reid | Clinical Psychologist | Western Psychological and Counseling PC | 9670 Sw Bear, Beaverton, OR 97005 |
| Cynthia Crowley Carr | Clinical Social Worker | Western Psychological and Counseling PC | 9670 Sw Bear, Hillsdale Hwy, Beaverton, OR 97005 |
| Roammie H Ko | Clinical Social Worker | Western Psychological and Counseling PC | 9670 Sw Bear, Beaverton, OR 97005 |
| Anne M Willis | Clinical Psychologist | Western Psychological and Counseling PC | 9670 Sw Bear, Hillsdale Hwy, Beaverton, OR 97005 |
| Laurie A Mahlbauer | Nurse Practitioner | Western Psychological and Counseling PC | 9670 Sw Bear, Hillsdale Hwy, Beaverton, OR 97005 |
| Margo C Pactanac | Clinical Social Worker | Western Psychological and Counseling PC | 9670 Sw Bear, Hillsdale Hwy, Beaverton, OR 97005 |
| Martha Villegas-gutierroz | Clinical Psychologist | Western Psychological and Counseling PC | 9670 Sw Bear, Hillsdale Hwy, Beaverton, OR 97005 |
| Carrie Lynn Binder | Nurse Practitioner | Praxis Medical Group Inc | 4510 Sw Hall Blvd, Beaverton, OR 97005-0504 |
| Leslie Cody | Nurse Practitioner | Praxis Medical Group Inc | 4510 Sw Hall Blvd, Beaverton, OR 97005-0504 |
| David P Harris | Physical Therapy | Praxis Medical Group Inc | 4510 Sw Hall Blvd, Beaverton, OR 97005-0504 |
| Find all physicians in zip 97005 | |||
| City | BEAVERTON |
| Zip Code | 97005 |
| Specialty | OPTOMETRY |
| City + Specialty | BEAVERTON + OPTOMETRY |
Please comment or provide details below to improve the information on Vitaliy Pelikhatyy.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.