Thien-Huong Theresa Van, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4816 NW Bethany Blvd
Portland, OR 97229-9254

Phone

(888) 227-3312

Fax

(971) 282-0100

NPI assigned

Sep 19, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Theresa Van Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Express Care Or PCGroup PAC ID 1254768732, 60 clinicians

Express Care Wa PCGroup PAC ID 6800128067, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Merit-based Incentive Payment System (MIPS)

Final score

89.78 of 100Reported as group

Quality

92.1

Improvement activities

40

Cost

80.43

Merit-based Incentive Payment System (MIPS)

Final score

89.49 of 100Reported as group

Quality

86.28

Promoting interoperability

100

Improvement activities

40

Cost

78.7

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tvan2427711@oc.providencedirect.org

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.

• Express Care Or PC

  • General Practice Physician
  • Portland, OR
  • NPI 1205499126

  WA

  Medicare reassignment Care Compare group
• Express Care Wa PC

  • General Practice Physician
  • Lacey, WA
  • NPI 1821554452

  OR

  Medicare reassignment Care Compare group
• Providence Health & Services - Washington

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
  • NPI 1043374119
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1164072286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4816 NW BETHANY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972299254",
            "telephone_number": "888-227-3312",
            "fax_number": "971-282-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 NW BETHANY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972299254",
            "telephone_number": "888-227-3312",
            "fax_number": "971-282-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3031 NE Stephens St",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974706237",
            "country_code": "US",
            "telephone_number": "541-229-7038",
            "fax_number": "541-464-4474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN",
        "first_name": "THIEN-HUONG",
        "middle_name": "THERESA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA202904",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2278171",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500791146",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Roseburg",
            "affiliation": "N",
            "address_1": "3031 NE Stephens St",
            "city": "Roseburg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974706237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "VAN",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Christina Van, PHARM D
• Jill Van, OTR/L
• Myco Van, PSY.D.
• Peter Van
• Philbert Y Van, M.D.
• Marika Joanna Vanadelsberg
• Lisa Ann Vanalstine, L.M.T.
• Courtney Lynn Vanbriesen, PHARMD.
• Elizabeth Vanbuecken, LMFT, RDT
• Sandra Carol Vancalcar, RD

• Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.

Verify at the official NPI Registry.