Individual provider Active NPI

Thuy Chu Tran, OD

  • Optometrist
  • Portland, OR
National Provider Identifier
1477576494
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4009ATI Issued in OR
Practice address
4526 NE Sandy Boulevard
Portland, OR 97213
Phone
(503) 284-9071
Fax
(503) 287-6169
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4009ATI OR Primary

Addresses

Primary practice location

4526 NE Sandy Boulevard
Portland, OR 97213

Mailing address

4526 NE Sandy Blvd
Portland, OR 97213-1438
Phone (503) 284-9071

Other identifiers 6

IdentifierTypeStateIssuer
0059253000OtherORFIRST CHOICE
0059253000OtherORBCBS
069336MedicaidOR
U55166OtherORBCBS, ODS, PROVIDENCE
5555758OtherORAETNA
U55166OtherORCIGNA

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
I20060727000052 OR Practitioner - Optometry 1557374139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2524 SE 122ND Ave
Portland, OR 97236-3101
Phone (503) 761-2121

4526 NE Sandy Blvd
Portland, OR 97213-1438
Phone (503) 284-9071

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4009ATIORMDOptometrist
4009ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Tran Optometry Clinic PC Optometrist CurrentSince Sep 9, 2010 Accepting new patients

Locations

2524 SE 122nd Ave
Portland, OR 97236
Phone (503) 761-2121

4526 NE Sandy Blvd
Portland, OR 97213
Phone (503) 284-9071

Organizations & group practices 1

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1477576494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4526 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131438",
            "telephone_number": "503-284-9071",
            "fax_number": "506-287-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4526 NE SANDY BOULEVARD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97213",
            "telephone_number": "503-284-9071",
            "fax_number": "503-287-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "THUY",
        "middle_name": "CHU",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4009ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CHOICE",
            "identifier": "0059253000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0059253000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069336",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS, ODS, PROVIDENCE",
            "identifier": "U55166",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5555758",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "U55166",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.