Individual provider Active NPI

Derek Jen Kon Louie, BS, MS, OD

  • Optometrist
  • Portland, OR
National Provider Identifier
1235281379
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3196ATI Issued in OR
Practice address
3375 SW Terwilliger Blvd
Portland, OR 97239
Phone
(503) 494-3000
Fax
(503) 494-3909
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3196ATI OR Primary

Addresses

Primary practice location

3375 SW Terwilliger Blvd
Portland, OR 97239

Mailing address

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-3000

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
I20070507000278 OR Practitioner - Optometry 9638104276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

2055 Exchange St
Suite 230
Astoria, OR 97103-3419
Phone (503) 338-3803

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Master of Science

State licenses

LicenseStateTypeSpecialty
2458OKMDChiropractor
3196ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Apr 1, 2010 Accepting new patients
University Professional Services CurrentSince Apr 1, 2010 Accepting new patients
Cherokee Nation Past Accepting new patients
Cherokee Nation PastSince Mar 1, 2021 Accepting new patients
University Professional Services Past Accepting new patients
Northeastern State University College of Optometry Optometrist PastSince Jul 1, 2025 Accepting new patients

Locations

2055 Exchange St
Ste 230
Astoria, OR 97103
Phone (503) 338-3803

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

1619 Woods Ct
Hood River, OR 97031
Phone (541) 386-1399

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3375 SW Terwilliger Blvd
Portland, OR 97239
Phone (503) 226-3916

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

1040 NW 22nd Ave
Ste 200
Portland, OR 97210
Phone (503) 413-6223

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/
  • Direct secure messaging: dlouieod13771@direct.ohsu.edu

Organizations & group practices 7

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 1

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1235281379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 SW TERWILLIGER BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-494-3000",
            "fax_number": "503-494-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIE",
        "first_name": "DEREK",
        "middle_name": "JEN KON",
        "credential": "BS, MS, OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3196ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.