Individual provider Active NPI

Khanh T Nguyen, O.D.

  • Optometrist
  • Portland, OR
National Provider Identifier
1396843611
Registry record updated Dec 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2637 Issued in OR
Practice address
5625 SE 48TH Ave
Portland, OR 97206-5620
Phone
(503) 788-5343
Fax
(503) 788-1116
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2637 OR Primary

Addresses

Primary practice location

5625 SE 48TH Ave
Portland, OR 97206-5620

Mailing address

5625 SE 48TH Ave
Portland, OR 97206-5620
Phone (503) 788-5343

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
I20060309000460 OR Practitioner - Optometry 3577570050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Health Northwest PCGroup PAC ID 9234039926, 72 clinicians

Practice addresses (Care Compare)

10819 SE Stark
Suite 200
Portland, OR 97216-3161
Phone (503) 255-2291

11086 SE Oak St
Milwaukie, OR 97222-6692
Phone (503) 656-4221

24601 SE Stark St
Troutdale, OR 97060-3355
Phone (503) 255-2291

5050 NE Hoyt St
Suite 445
Portland, OR 97213-2984
Phone (503) 231-0166

6701 NE Glisan St
Portland, OR 97213-5553
Phone (503) 255-2291

Merit-based Incentive Payment System (MIPS)

Final score
88.74 of 100Reported as group
Quality
85.23
Promoting interoperability
100
Improvement activities
40
Cost
77.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Health Northwest P.C. Optometrist CurrentSince Dec 13, 2022 Accepting new patients
Eye Health Northwest, PC CurrentSince Dec 13, 2022 Accepting new patients

Locations

6701 NE Glisan St
Portland, OR 97213
Phone (503) 255-2291

11086 SE Oak St
Portland, OR 97222
Phone (503) 557-2020

10819 SE Stark St
Portland, OR 97216
Phone (503) 255-2291

Interoperability endpoints

  • Direct secure messaging: khanh.nguyen@direct.ehnpc.nextgenshare.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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1396843611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 SE 48TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972065620",
            "telephone_number": "503-788-5343",
            "fax_number": "503-788-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 SE 48TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972065620",
            "telephone_number": "503-788-5343",
            "fax_number": "503-788-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KHANH",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.