Individual provider Active NPI

Rani Bui, PA

  • Physician Assistant
  • Tualatin, OR
National Provider Identifier
1679347843
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA217746 Issued in OR
Practice address
19260 SW 65TH Ave Ste 270
Tualatin, OR 97062-5705
Phone
(503) 692-9525
Fax
(503) 692-8643
NPI assigned
Nov 8, 2023
Last updated
Nov 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA217746 OR Primary

Addresses

Primary practice location

19260 SW 65TH Ave Ste 270
Tualatin, OR 97062-5705

Mailing address

19260 SW 65TH Ave Ste 270
Tualatin, OR 97062-5705

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240221000752 OR Practitioner - Physician Assistant 7214371947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clackamas Dermatology PCGroup PAC ID 4183618440, 11 clinicians

Practice addresses (Care Compare)

12605 SE 97TH Ave
Clackamas, OR 97015-9706
Phone (503) 654-7546

1620 SW 257TH Ave
Troutdale, OR 97060-1490
Phone (503) 654-7546

545 SE Oak St
Hillsboro, OR 97123-4147
Phone (503) 654-7546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clackamas Dermatology PC CurrentSince Feb 1, 2025 Accepting new patients
Allergy Asthma & Dermatology Associates PC Past Accepting new patients

Locations

12605 SE 97th Ave
Clackamas, OR 97015
Phone (503) 654-7546

545 SE Oak St
Hillsboro, OR 97123
Phone (503) 654-7546

1620 SW 257th Ave
Troutdale, OR 97060
Phone (503) 654-7546

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1679347843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19260 SW 65TH AVE STE 270",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970625705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19260 SW 65TH AVE STE 270",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970625705",
            "telephone_number": "503-692-9525",
            "fax_number": "503-692-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUI",
        "first_name": "RANI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA217746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

Verify at the official NPI Registry.