Organization Active NPI

Tran Optometry Clinic PC

  • Optometrist
  • Portland, OR
National Provider Identifier
1487959920
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4009T Issued in OR
Legal business name
TRAN OPTOMETRY CLINIC PC
Practice address
4526 NE Sandy Blvd
Portland, OR 97213-1438
Phone
(503) 284-9071
NPI assigned
Jan 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Authorized official

Name
Thuy C Tran, ODNPI 1477576494
Title
President
Phone
(503) 284-9071

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4009T OR Primary

Addresses

Primary practice location

4526 NE Sandy Blvd
Portland, OR 97213-1438

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
069336MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110211000875 OR Part B Supplier - Clinic/Group Practice 5294915955 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

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

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1487959920",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4526 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131438",
            "telephone_number": "503-284-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAN OPTOMETRY CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "THUY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-284-9071",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4009T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069336",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.