Individual provider Active NPI

Vicky Hoang Nguyen, PA-C

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1811570807
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA217371 Issued in OR
Practice address
9427 SW Barnes Rd Ste 390
Portland, OR 97225-6652
Phone
(503) 216-2111
NPI assigned
Apr 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 PA217371 OR Primary

Addresses

Primary practice location

9427 SW Barnes Rd Ste 390
Portland, OR 97225-6652

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice location 1

375 S Chipeta Way Ste A
Salt Lake City, UT 84108-1261
Phone (801) 581-7766

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
I20241205002360 OR Practitioner - Physician Assistant 5496281065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

440 NW Division St
Gresham, OR 97030-5506
Phone (503) 215-9500

9427 SW Barnes Rd
Portland, OR 97225-6652

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Jan 6, 2025 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 6, 2025 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

9427 SW Barnes Rd
Ste 390
Portland, OR 97225
Phone (503) 216-1280

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 1

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": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1811570807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9427 SW BARNES RD STE 390",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256652",
            "telephone_number": "503-216-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 S Chipeta Way Ste A",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841081261",
            "country_code": "US",
            "telephone_number": "801-581-7766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VICKY",
        "middle_name": "HOANG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA217371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.