Individual provider Active NPI

Minh Duc Nguyen, OTD

  • Occupational Therapist
  • Salem, OR
National Provider Identifier
1821263534
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1130 Liberty St SE Ste 2
Salem, OR 97302-4143
Phone
(503) 339-7781
Fax
(503) 991-5355
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

1130 Liberty St SE Ste 2
Salem, OR 97302-4143

Mailing address

4157 Geranium Ave NE
Salem, OR 97305-3924
Phone (503) 851-2453

Other practice location 1

1910 S 72nd St
Ste 302
Omaha, NE 68124-1743
Phone (402) 391-2635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180328002282 OR Practitioner - Occupational Therapist in Private Practice 5496015638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Creighton University School of Medicine, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1180 Cross St SE
Salem, OR 97302-2924
Phone (503) 339-7781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rejuvenation Therapy Pain Clinic, LLP Occupational Therapist CurrentSince Feb 6, 2018 Accepting new patients

Locations

1180 Cross St SE
Salem, OR 97302
Phone (503) 339-7781

1130 Liberty St SE
Ste 2
Salem, OR 97302
Phone (503) 339-7781

Organizations & group practices 1

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": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1821263534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4157 GERANIUM AVE NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973053924",
            "telephone_number": "503-851-2453",
            "fax_number": "503-991-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 LIBERTY ST SE STE 2",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024143",
            "telephone_number": "503-339-7781",
            "fax_number": "503-991-5355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1910 S 72nd St",
            "address_2": "Ste 302",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681241743",
            "country_code": "US",
            "telephone_number": "402-391-2635",
            "fax_number": "402-391-0326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MINH",
        "middle_name": "DUC",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.