Individual provider Active NPI

Nhung DO, OD

  • Optometrist
  • Medford, OR
National Provider Identifier
1902570914
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ATI4593 Issued in OR
Practice address
221 W Stewart Ave Ste 110
Medford, OR 97501-3647
Phone
(541) 776-9026
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ATI4593 OR Primary

Addresses

Primary practice location

221 W Stewart Ave Ste 110
Medford, OR 97501-3647

Mailing address

221 W Stewart Ave Ste 110
Medford, OR 97501-3647
Phone (541) 494-5325

Other practice location 1

1333 E Barnett Rd
Medford, OR 97504-8219
Phone (541) 779-4711

Other identifiers 1

IdentifierTypeStateIssuer
5000796034MedicaidOR

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
I20210817003401 OR Practitioner - Optometry 4688079429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Eye Center IncGroup PAC ID 8325034804, 15 clinicians

Practice addresses (Care Compare)

1333 E Barnett Rd
Medford, OR 97504-8219
Phone (541) 779-4711

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.1

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ATI4593ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Eye Center Inc Optometrist CurrentSince Sep 1, 2022 Accepting new patients
Medical Eye Center Optical Inc Past Accepting new patients

Locations

881 NE 7th St
Grants Pass, OR 97526
Phone (541) 476-6302

221 W Stewart Ave
Ste 110
Medford, OR 97501
Phone (541) 776-9026

1333 E Barnett Rd
Medford, OR 97504
Phone (541) 779-4711

Interoperability endpoints

  • Direct secure messaging: ndo@directaddress.net

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": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1902570914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W STEWART AVE STE 110",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013647",
            "telephone_number": "541-494-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W STEWART AVE STE 110",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013647",
            "telephone_number": "541-776-9026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 E Barnett Rd",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048219",
            "country_code": "US",
            "telephone_number": "541-779-4711",
            "fax_number": "541-779-0796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DO",
        "first_name": "NHUNG",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5000796034",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.