Individual provider Active NPI

Yume Kim Paige, OD

  • Optometrist
  • Happy Valley, OR
National Provider Identifier
1770069650
Registry record updated Mar 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ATI4553 Issued in OR
Practice address
13180 SE 169TH Ave Ste 104
Happy Valley, OR 97086-8727
Phone
(503) 698-2375
Fax
(503) 251-3761
NPI assigned
Jul 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ATI4553 OR Primary

Addresses

Primary practice location

13180 SE 169TH Ave Ste 104
Happy Valley, OR 97086-8727

Mailing address

13180 SE 169TH Ave Ste 104
Happy Valley, OR 97086-8727
Phone (503) 698-2375

Other names 1

  • Dung Kim Nguyen Former name

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210205001726 OR Practitioner - Optometry 8729401401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Eye Care LLCGroup PAC ID 9234525783, 3 clinicians

Practice addresses (Care Compare)

13180 SE 169TH Ave
Suite 104
Happy Valley, OR 97086-8727
Phone (503) 698-2375

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ATI4553ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Eye Care LLC Optometrist CurrentSince Apr 29, 2022 Accepting new patients
Double Vision Inc Optometrist CurrentSince Jul 1, 2021 Accepting new patients

Locations

13180 SE 169th Ave
Ste 104
Happy Valley, OR 97086
Phone (503) 252-2375

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": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741392000000",
    "number": "1770069650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13180 SE 169TH AVE STE 104",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970868727",
            "telephone_number": "503-698-2375",
            "fax_number": "503-251-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13180 SE 169TH AVE STE 104",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970868727",
            "telephone_number": "503-698-2375",
            "fax_number": "503-251-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIGE",
        "first_name": "YUME",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DUNG",
            "last_name": "NGUYEN",
            "middle_name": "KIM",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Happy Valley, OR

Sources for this page

Verify at the official NPI Registry.