Individual provider Active NPI

Trung Phu Chung, PA-C

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1720489297
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA174588 Issued in OR
Practice address
4816 NW Bethany Blvd
Portland, OR 97229-9254
Phone
(888) 227-3312
Fax
(971) 282-0100
NPI assigned
Sep 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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 PA174588 OR Primary

Addresses

Primary practice location

4816 NW Bethany Blvd
Portland, OR 97229-9254

Mailing address

PO Box 2908
Portland, OR 97208-2908
Phone (252) 075-1554

Other practice location 1

135 NE 102nd Ave
Portland, OR 97220-4167
Phone (503) 894-9005

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151021002961 OR Practitioner - Physician Assistant 8224347802 Reassigns benefits to 2 organizations
I20181120003114 WA Practitioner - Physician Assistant 8224347802 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Express Care Wa PCGroup PAC ID 6800128067, 64 clinicians
Express Care Or PCGroup PAC ID 1254768732, 60 clinicians

Practice addresses (Care Compare)

1025 NW 14TH Ave
Portland, OR 97209-2705
Phone (888) 227-3312

11995 SE Sunnyside Rd
Happy Valley, OR 97015-9312
Phone (888) 227-3312

1336 NE Orenco Station Pkwy
Hillsboro, OR 97124-5408
Phone (888) 227-3312

3822 SE Powell Blvd
Portland, OR 97202-1720
Phone (888) 227-3312

4340 N Interstate Ave
Portland, OR 97217-3211
Phone (888) 227-3312

4823 Meadows Rd
Suite 127
Lake Oswego, OR 97035-2622
Phone (888) 227-3312

5308 N Lombard St
Suite 102
Portland, OR 97203-4218
Phone (888) 227-3312

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.78 of 100Reported as group
Quality
92.1
Improvement activities
40
Cost
80.43

Merit-based Incentive Payment System (MIPS)

Final score
89.49 of 100Reported as group
Quality
86.28
Promoting interoperability
100
Improvement activities
40
Cost
78.7

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Washington Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tchung3220865@oc.providencedirect.org
  • Direct secure messaging: tchung3219958@wm.providencedirect.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1720489297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2908",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082908",
            "telephone_number": "252-075-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 NW BETHANY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972299254",
            "telephone_number": "888-227-3312",
            "fax_number": "971-282-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 NE 102nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972204167",
            "country_code": "US",
            "telephone_number": "503-894-9005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "TRUNG",
        "middle_name": "PHU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-15",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA174588",
            "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": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "135 NE 102nd Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972204167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.