Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1558576546 Individual Practitioner Male Practitioner

Dr. Jonathan Russell , OD

Optometrist • Clackamas, OR

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Jonathan Russell, OD is a certified Optometrist practicing in Clackamas, OR. With approximately 25 years of clinical experience since graduating from Pacific University - College Of Optometry in 2001, Dr. Russell delivers high-quality medical care to the local community at 12100 SE STEVENS CT.

Dr. Russell is affiliated with Kaiser Foundation Health Plan Of The Northwest and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient complete exam of visual system. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

12100 Se Stevens Ct
Suite 106

Clackamas, OR 970864707

Telephone 5033537300
Associated Practice Facility / Clinic
🏢 Lee Ghorbanian I Ltd Facility NPI 1710295407

Medicare Profile & Education

Medical School

Pacific University - College Of Optometry

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Clackamas, OR

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
25 Yrs +10.1 yrs vs City Avg
City Avg: 14.9 Yrs
State Avg: 19.6 Yrs
Regional Practice Density
17 Specialists

Practicing in Clackamas, OR (975 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
0.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Russell (25 Years) 25 Yrs
Clackamas Specialty Average (14.9 Years) 14.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92014 Established patient complete exam of visual system
12 11 $130.00 $128.79

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License OR 2838T

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.

Hospital & Practice Group Affiliations

Kaiser Foundation Health Plan Of The Northwest

14406 Ne 20th Ave, Vancouver, WA 986861448

Phone: 8008132000

Kaiser Foundation Health Plan Of The Northwest

12100 Se Stevens Ct, Portland, OR 970864707

Phone: 8008132000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Patrick Buczkowski , OPTICIAN

Technician/Technologist - Optician

NPI 1043326085
Dannica Hawes , LDO

Technician/Technologist - Optician

NPI 1124110010
Dr. Paula Wynn , MD

Ophthalmology

NPI 1437367059

Doctor of Medicine (M.D.)

Heather Gallagher , LDO

Technician/Technologist - Optician

NPI 1598853897
NPI 1669567780

Doctor of Optometry

Adolphe Bonfiglio

Technician/Technologist - Optometric Technician

NPI 1780897942

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 19, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location August 19, 2015

Registered at 12100 SE STEVENS CT, SUITE 106, CLACKAMAS, OR 970864707 (Tel: 5033537300)

📍
Updated Business Mailing Address August 19, 2015

Registered at 4435 SE 43RD AVE, PORTLAND, OR 972064003

👤
Provider Name / Credentials Updated August 19, 2015

Recorded as JONATHAN RUSSELL, OD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2015

Optometrist (License #2838T in OR)

🟢
Initial NPI Registration & Enumeration May 11, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1558576546
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 11, 2007
Last Update: August 19, 2015
Sole Proprietor: Yes

Mailing Address

4435 Se 43rd Ave

Portland, OR 972064003

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.