Individual provider Active NPI

John Nguyen, D.O

  • Family Medicine Physician
  • Tigard, OR
National Provider Identifier
1164847679
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO193061 Issued in OR
Practice address
13200 SW Pacific Hwy
Tigard, OR 97223-4828
Phone
(503) 598-2000
Fax
(503) 639-0920
NPI assigned
Feb 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DO193061 OR Primary

Addresses

Primary practice location

13200 SW Pacific Hwy
Tigard, OR 97223-4828

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200210000113 OR Practitioner - Family Practice 5294029096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

13200 SW Pacific Hwy
Tigard, OR 97223-4828
Phone (503) 598-2000

Hospital & facility affiliations

  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Health, PC CurrentSince Jan 1, 2020 Accepting new patients
Praxis Health, PC Family Medicine CurrentSince Jan 1, 2020 Accepting new patients

Locations

4510 SW Hall Blvd
Beaverton, OR 97005
Phone (503) 644-1171

1001 Molalla Ave
Ste 100
Oregon City, OR 97045
Phone (503) 656-5273

13200 SW Pacific Hwy
Tigard, OR 97223
Phone (503) 598-2000

Interoperability endpoints

  • Direct secure messaging: jvnguyen@pacificmedicalgroup.directbygreenway.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1164847679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13200 SW PACIFIC HWY",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972234828",
            "telephone_number": "503-598-2000",
            "fax_number": "503-639-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOHN",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-20",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO193061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.