Individual provider Active NPI

Thomas Nguyen

  • Optometrist
  • Clackamas, OR
National Provider Identifier
1740860147
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ATI4570 Issued in OR
Practice address
12100 SE Stevens Rd
Clackamas, OR 97086
Phone
(503) 813-2000
NPI assigned
Apr 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ATI4570 OR Primary
Optometrist 152W00000X 61327713 WA

Addresses

Primary practice location

12100 SE Stevens Rd
Clackamas, OR 97086

Mailing address

500 NE Multnomah St Ste 100
Portland, OR 97232-2099
Phone (800) 813-2000

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210628002071 OR Practitioner - Optometry 1951702992 Reassigns benefits to 1 organization
I20221019002753 WA Practitioner - Optometry 1951702992 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

12100 SE Stevens CT
Suite 106
Portland, OR 97086-4707
Phone (800) 813-2000

Merit-based Incentive Payment System (MIPS)

Final score
90.47 of 100Reported as group
Quality
100
Promoting interoperability
89
Improvement activities
40
Cost
77.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ATI4570ORMDOptometrist
61327713WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients
Vancouver Eye Care PS CurrentSince Sep 1, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 12, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 12, 2023 Accepting new patients
Vancouver Eye Care, P.S. Optometrist CurrentSince Sep 1, 2022 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

12100 SE Stevens Ct
Ste 106
Portland, OR 97086
Phone (503) 331-6330

500 NE Multnomah St
Ste 100
Portland, OR 97232
Phone (503) 499-5200

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

3200 Main St
Vancouver, WA 98663
Phone (360) 696-4691

2415 NE 134th St
Ste 101
Vancouver, WA 98686
Phone (360) 823-2000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1740860147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322099",
            "telephone_number": "800-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 SE STEVENS RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97086",
            "telephone_number": "503-813-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-09",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4570",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "61327713",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.