Active NPI
Tina Diem Vuong
- Optometrist
- Forest Grove, OR
National Provider Identifier
1053109983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ATI4792
- Practice address
- 2043 College Way
Forest Grove, OR 97116-1797 - Phone
- (503) 352-6151
- NPI assigned
- Apr 29, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Optometrist | 152W00000X | ATI4792 | OR | Primary |
Addresses
Primary practice location
2043 College Way
Forest Grove, OR 97116-1797
Mailing address
2225 NE 88TH Ave
Portland, OR 97220-5430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260523000260 | OR | Practitioner - Optometry | 6709351463 |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1594 Edgewater St NW
Suite 190
Salem, OR 97304-4656
Phone (541) 762-2763
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ATI4792 | OR | MD | Optometrist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Ophthalmology Physician
- Eugene, OR
- NPI 1902161946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755302400000",
"number": "1053109983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2225 NE 88TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972205430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2043 COLLEGE WAY",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "971161797",
"telephone_number": "503-352-6151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VUONG",
"first_name": "TINA",
"middle_name": "DIEM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-29",
"last_updated": "2025-08-16",
"certification_date": "2025-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "ATI4792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Forest Grove, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.