Phuc Minh Nguyen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4356ATI Issued in OR

Practice address

6375 Ulali Dr NE
Keizer, OR 97303-1697

Phone

(503) 428-5096

NPI assigned

Mar 13, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ogata Eyecare PCGroup PAC ID 2466351606, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ogata Eyecare, PC

  • Optometrist
  • Tigard, OR
  • NPI 1841378221
  Medicare reassignment Care Compare group NPD
• Ogata Eyecare, PC

  • Optometrist
  • Portland, OR
  • NPI 1427124312
  NPD
• Consolidated Vision Group

  • Eyewear Supplier
  • Keizer, OR
  • NPI 1285806281
  NPD (past)

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1407359771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 MEADOW PARK LOOP NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6375 ULALI DR NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973031697",
            "telephone_number": "503-428-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUC",
        "middle_name": "MINH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4356ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Namaste Massage and Spa
• Theron Nebeker, D.M.D
• Muoi Riley Nguyen Cole, PSYD
• Mellisa Phuong Nguyen, OD
• Pascal V Nguyen, DMD
• Emily Nichol
• Justin Scott Nielsen, CADCII
• Northland Hearing Center, Inc.
• Northwest Center for Evidence-Based Psychotherapy LLC
• Northwest Counseling and Wellness LLC

• Optometrist in Keizer, OR
• Providers in Keizer, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.