Individual provider Active NPI

Phu Ngoc Hoang, O.D.

  • Optometrist
  • Portland, OR
National Provider Identifier
1326473505
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AT-3535 Issued in OR
Practice address
1370 SE 122ND Ave
Portland, OR 97233-1203
Phone
(503) 432-0379
NPI assigned
Sep 6, 2013
Last updated
May 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AT-3535 OR Primary

Addresses

Primary practice location

1370 SE 122ND Ave
Portland, OR 97233-1203

Mailing address

1370 SE 122ND Ave
Portland, OR 97233-1203
Phone (503) 432-0379

Other practice location 1

813-A Adams Ave
Philadelphia, PA 19124
Phone (215) 289-0200

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
I20200311002204 OR Practitioner - Optometry 8325476039 Practice locations: Portland, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT-3535ORMDOptometrist
3535ORMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Opticare Optometry Optometrist CurrentSince Sep 9, 2019 Accepting new patients
New World Vision Center II Optometrist PastSince May 12, 2023 Accepting new patients

Locations

1370 SE 122nd Ave
Portland, OR 97233
Phone (503) 252-7317

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": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1326473505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 SE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331203",
            "telephone_number": "503-432-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 SE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331203",
            "telephone_number": "503-432-0379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "813-A Adams Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19124",
            "country_code": "US",
            "telephone_number": "215-289-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOANG",
        "first_name": "PHU",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "AT-3535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.