Individual provider Active NPI

Tammy T Nguyen

  • Optometrist
  • Tigard, OR
National Provider Identifier
1457973992
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ATI4550 Issued in OR
Practice address
9169 SW Burnham St
Tigard, OR 97223-6105
Phone
(503) 639-5115
NPI assigned
May 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ATI4550 OR Primary

Addresses

Primary practice location

9169 SW Burnham St
Tigard, OR 97223-6105

Mailing address

9169 SW Burnham St
Tigard, OR 97223-6105

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
I20201118001096 OR Practitioner - Optometry 9739590084 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Murray Scholls Optique IncGroup PAC ID 1658357967, 3 clinicians
West Linn Vision Center IncGroup PAC ID 7315227634, 3 clinicians
Tigard Vision Center, Inc.Group PAC ID 1355339300, 4 clinicians

Practice addresses (Care Compare)

14600 SW Murray Scholls
Suite 104
Beaverton, OR 97007-9712
Phone (503) 579-6695

2020 8TH Ave
Suite a
West Linn, OR 97068-4657
Phone (503) 652-1479

9169 Southwest Burnham
Tigard, OR 97223-6105
Phone (503) 639-5115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ATI4550ORMDOptometrist
4550ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Linn Vision Center Inc Optometrist CurrentSince Nov 16, 2023 Accepting new patients
Murray Scholls Optique Inc Optometrist CurrentSince Apr 14, 2022 Accepting new patients
Tigard Vision Center, Inc. Optometrist CurrentSince Nov 4, 2020 Accepting new patients

Locations

14600 SW Murray Scholls Dr
Ste 104
Beaverton, OR 97007
Phone (503) 579-6695

9169 SW Burnham St
Tigard, OR 97223
Phone (503) 539-5115

2020 8th Ave
Ste A
West Linn, OR 97068
Phone (503) 303-5591

2020 8th Ave
West Linn, OR 97068
Phone (503) 652-1479

Interoperability endpoints

  • Direct secure messaging: tammy.nguyen@direct.revolutionehr.com

Organizations & group practices 3

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": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1457973992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9169 SW BURNHAM ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9169 SW BURNHAM ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236105",
            "telephone_number": "503-639-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TAMMY",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2021-07-09",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.