Individual provider Active NPI

Lynne My Nguyen, PA-C

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1760663736
Registry record updated Oct 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
PA01288 Issued in OR
Practice address
3202 SE 82ND Ave
Portland, OR 97266-2004
Phone
(503) 777-5995
Fax
(503) 777-8005
NPI assigned
Nov 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X PA01288 OR
Internal Medicine Physician 207R00000X PA01288 OR Primary

Addresses

Primary practice location

3202 SE 82ND Ave
Portland, OR 97266-2004

Mailing address

3202 SE 82ND Ave
Portland, OR 97266-2004
Phone (503) 777-5995

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
I20080108000748 OR Practitioner - Physician Assistant 6305926957 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01288ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Pharmacy LLC PastSince Jun 21, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lynne.nguyen.1@11271.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255046400000",
    "number": "1760663736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 SE 82ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662004",
            "telephone_number": "503-777-5995",
            "fax_number": "503-777-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 SE 82ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662004",
            "telephone_number": "503-777-5995",
            "fax_number": "503-777-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LYNNE",
        "middle_name": "MY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2009-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OR",
            "license": "PA01288",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "PA01288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.