Individual provider Active NPI

Christina Nguyen, OD

  • Optometrist
  • Salem, OR
National Provider Identifier
1679003313
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4380-AT Issued in OR
Practice address
2400 Lancaster Dr NE
Salem, OR 97305-1221
Phone
(800) 813-2000
NPI assigned
Jun 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 60771160 WA
Optometrist 152W00000X 4380-AT OR Primary

Addresses

Primary practice location

2400 Lancaster Dr NE
Salem, OR 97305-1221

Mailing address

2400 Lancaster Dr NE
Salem, OR 97305-1221
Phone (503) 312-8366

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Northwest Permanente PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180824001945 WA Practitioner - Optometry 4789933698 Reassigns benefits to 2 organizations
I20181121000256 OR Practitioner - Optometry 4789933698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 Lancaster Dr NE
Salem, OR 97305-1221
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4380-ATORMDOptometrist
60771160WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 24, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 24, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 24, 2018 Accepting new patients
Blue Mountain Eye PLLC CurrentSince Jun 13, 2018 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

1025 S 2nd Ave
Walla Walla, WA 99362
Phone (509) 525-0480

1610 Penny Ln
Walla Walla, WA 99362
Phone (509) 529-3160

Organizations & group practices 4

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1679003313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051221",
            "telephone_number": "503-312-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051221",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CHRISTINA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60771160",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4380-AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Northwest Permanente PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Lancaster Dr NE",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973051221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.