Individual provider Active NPI

Tommy Vu, PA

  • Surgical Physician Assistant
  • Salem, OR
National Provider Identifier
1750784039
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA17081 Issued in OR
Practice address
1600 State St
Salem, OR 97301-4257
Phone
(503) 540-6300
Fax
(503) 540-6404
NPI assigned
Oct 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA170181 OR
Surgical Physician Assistant 363AS0400X PA17081 OR Primary

Addresses

Primary practice location

1600 State St
Salem, OR 97301-4257

Mailing address

1600 State St
Salem, OR 97301-4257
Phone (503) 540-6300

Other practice location 1

5825 Shoreview Ln N
Keizer, OR 97303-3978
Phone (503) 540-6471

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
I20141223001528 OR Practitioner - Physician Assistant 8426371493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

1600 State St
Salem, OR 97301-4257
Phone (503) 561-5200

5825 Shoreview LN N
Keizer, OR 97303-3978
Phone (503) 561-5200

665 Winter St SE
Salem, OR 97301-3934
Phone (503) 561-5200

890 Oak St SE
Salem, OR 97301-3905
Phone (503) 561-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA170181ORMDPhysician Assistant
PA17081ORMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health CurrentSince Oct 7, 2023 Accepting new patients

Locations

5825 Shoreview Ln N
Keizer, OR 97303
Phone (503) 540-6471

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

700 Bellevue St SE
Salem, OR 97301
Phone (503) 399-8105

875 Oak St SE
Ste 5010
Salem, OR 97301
Phone (503) 391-5133

1600 State St
Salem, OR 97301
Phone (503) 540-6472

Interoperability endpoints

  • Direct secure messaging: tvu102265@direct.salemhealth.org

Organizations & group practices 2

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": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1750784039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014257",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014257",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5825 Shoreview Ln N",
            "address_purpose": "LOCATION",
            "city": "Keizer",
            "state": "OR",
            "postal_code": "973033978",
            "country_code": "US",
            "telephone_number": "503-540-6471",
            "fax_number": "503-540-6404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VU",
        "first_name": "TOMMY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-01",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA170181",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA17081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.