Madras Vision Source PC
NPI 1164791414 · Optometrist · Madras, OR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Madras Vision Source PC is a Optometrist organization in Madras, OR (NPI 1164791414).
Provider details
- NPI number
- 1164791414
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Parent organization
- Madras Vision Source PC
- Organization subpart
- Yes
- Authorized official
- Jessica Tegan, Owner(541) 475-2020
Specialties & taxonomies
Eye and Vision Services Providers
- Eyewear Supplier332H00000X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- Madras Vision Source LLC
Registry dates
- Enumerated
- 2011-12-15
- Last updated
- 2022-05-17
- Certified
- 2022-05-17
Frequently asked questions
- What is Madras Vision Source PC's NPI number?
- Madras Vision Source PC's National Provider Identifier (NPI) is 1164791414, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Madras Vision Source PC?
- Madras Vision Source PC is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
- Where is Madras Vision Source PC located?
- Madras Vision Source PC's practice location on file with NPPES is 211 Se 5th St, Madras, OR 97741.
- What is Madras Vision Source PC's phone number?
- The practice phone number listed in the NPPES registry for Madras Vision Source PC is (541) 475-2020.
- Does Madras Vision Source PC accept Medicare?
- Madras Vision Source PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Madras Vision Source PC?
- The authorized official listed on Madras Vision Source PC's NPPES record is Jessica Tegan, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Madras Vision Source PC's NPI active?
- Yes — Madras Vision Source PC's NPI (1164791414) is active in the NPPES registry as of the last update on 2022-05-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.