Individual provider Active NPI

Jessica Buivu Nguyen, PA-C

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1942964903
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA207631 Issued in OR
Practice address
9701 SW Barnes Rd Ste 200
Portland, OR 97225-6689
Phone
(503) 734-3700
Fax
(503) 473-8462
NPI assigned
Oct 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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 PA207631 OR Primary

Addresses

Primary practice location

9701 SW Barnes Rd Ste 200
Portland, OR 97225-6689

Mailing address

7650 SW Beveland Rd Ste 200
Portland, OR 97223-8692
Phone (503) 601-3615

Other identifiers 1

IdentifierTypeStateIssuer
500801614MedicaidOR

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
I20211203000909 OR Practitioner - Physician Assistant 4183014269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Womens Healthcare Associates LLCGroup PAC ID 8527054014, 103 clinicians

Practice addresses (Care Compare)

1508 Division St
Suite 205
Oregon City, OR 97045-1585
Phone (503) 657-1071

9701 SW Barnes Rd
Portland, OR 97225-6689

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA207631ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Urology, LLC PastSince Oct 31, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jbuivunguyen619835@direct.lhs.org

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.

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": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1942964903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 SW BEVELAND RD STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238692",
            "telephone_number": "503-601-3615",
            "fax_number": "503-646-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 SW BARNES RD STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256689",
            "telephone_number": "503-734-3700",
            "fax_number": "503-473-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JESSICA",
        "middle_name": "BUIVU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA207631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500801614",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.