Active NPI
Kenneth Ngo
- Optometrist
- Salem, OR
National Provider Identifier
1831986124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4843AT
- Practice address
- 990 Broadway St NE
Salem, OR 97301-1421 - Phone
- (503) 364-0767
- Fax
- (503) 581-8340
- NPI assigned
- Apr 22, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4843AT | OR | Primary |
Addresses
Primary practice location
990 Broadway St NE
Salem, OR 97301-1421
Mailing address
990 Broadway St NE
Salem, OR 97301-1421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3333 Quality Dr
Rancho Cordova, CA 95670-7986
8323 Mission Estates Dr
Houston, TX 77083-5338
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784160000000",
"number": "1831986124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 BROADWAY ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973011421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 BROADWAY ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973011421",
"telephone_number": "503-364-0767",
"fax_number": "503-581-8340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGO",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-04-22",
"last_updated": "2026-07-16",
"certification_date": "2026-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "4843AT",
"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 Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.