Individual provider Active NPI

Tuan Tu Nguyen, OD

  • Optometrist
  • Portland, OR
National Provider Identifier
1194737916
Registry record updated Mar 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2987T Issued in OR
Practice address
1274 SE 182ND Ave
Portland, OR 97233
Phone
(503) 669-1992
Fax
(503) 618-8262
NPI assigned
Aug 12, 2006
Last updated
Mar 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2987T OR Primary

Addresses

Primary practice location

1274 SE 182ND Ave
Portland, OR 97233

Mailing address

929 NE 181St Ave
Portland, OR 97230-6757
Phone (503) 669-1992

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051212000767 OR Practitioner - Optometry 7214958784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

929 NE 181St Ave
Portland, OR 97230-6757
Phone (503) 669-1992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2987TORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gresham Vision Source PC Optometrist CurrentSince Jul 1, 2006 Accepting new patients
Broadway Vision World Optometrist Past Accepting new patients

Locations

1274 SE 182nd Ave
Portland, OR 97233
Phone (503) 669-1992

929 NE 181st Ave
Portland, OR 97230
Phone (503) 669-1992

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1194737916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 NE 181ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306757",
            "telephone_number": "503-669-1992",
            "fax_number": "503-618-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1274 SE 182ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97233",
            "telephone_number": "503-669-1992",
            "fax_number": "503-618-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TUAN",
        "middle_name": "TU",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2987T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.