DR. KEVIN GIA-MINH PHAN OD
NPI 1164065959
Optometrist in Happy Valley, OR

Q: What is Kevin Phan's NPI number?

The NPI number for Kevin Phan is 1164065959. It was assigned to this individual provider in the NPPES registry on October 24, 2019.

Q: What is Kevin Phan's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Phan was last updated on September 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 24, 2019PECOS Enrolled

95.91/100

CMS Quality Rating

12000 SE 82ND AVE STE 2193, HAPPY VALLEY, OR 97086(503) 654-6217(503) 654-9335 Get Directions Write a Review

NPPES record last updated: September 12, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Kevin Gia-minh Phan Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEVIN GIA-MINH PHAN OD (NPI 1164065959) is an individual optometrist in Happy Valley, Oregon, licensed in Oregon (4708) and active in the NPI registry since October 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164065959

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. KEVIN GIA-MINH PHANCredential: OD

Location Address12000 SE 82ND AVE STE 2193Happy Valley, OR 97086-7746

Mailing Address11084 Se 64th AvePortland, OR 97222-2319 · (503) 890-7209

Phone(503) 654-6217

Fax(503) 654-9335

Sole ProprietorNo

Enumeration DateOctober 24, 2019

Last NPPES UpdateSeptember 12, 2023

NPPES CertifiedSeptember 12, 2023

✔ NPI 1164065959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Licenses✔ Licensed in OR · 4708✔ Licensed in WA · 60964432

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

12000 SE 82ND AVE STE 2193, Happy Valley, OR 97086

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming, BridgeSpan Health Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kevin Gia-minh Phan Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kevin Phan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pacific Eye Group, PC

111 mi

Optometrist

63455 N HWY 97 STE 75
Bend, OR 97703

Reassigned Medicare billing, Oregon and Washington enrollments
20 clinicians in this Medicare group

NPI 1831656925 (541) 389-5207

Charles Sung MD PC

170 mi

Ophthalmology

317 N DELAWARE ST
Kennewick, WA 99336

Reassigned Medicare billing, Washington enrollment
4 clinicians in this Medicare group

NPI 1245358050 (509) 736-5550

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97086 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$134.16 typical visit price

range $58.99 – $176.88

Typical copayment $33.54 (range $14.74 – $44.22)

Most-billed visit code 99204

Established Patient

$73.28 typical visit price

range $19.32 – $144.79

Typical copayment $18.32 (range $4.83 – $36.19)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.91/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

88.52

Improvement Activities

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PACIFIC EYE GROUP, PC

Optometrist

12000 SE 82ND AVE STE 2193
HAPPY VALLEY, OR 97086

Clackamas County (425) 329-2722

VISIONWORKS, INC.

Eyewear Supplier

12000 SE 82ND AVE STE 2193
HAPPY VALLEY, OR 97086

Clackamas County (503) 659-5947

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Phan's NPI number?

The NPI number for Kevin Phan is 1164065959. It was assigned to this individual provider in the NPPES registry on October 24, 2019.

Where is Kevin Phan located?

Kevin Phan practices at 12000 SE 82nd Ave Ste 2193, Happy Valley, OR 97086. The listed phone number is (503) 654-6217.

What is Kevin Phan's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Kevin Phan enrolled in Medicare?

Yes. Kevin Phan is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kevin Phan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Phan reassigns Medicare benefits to 2 organizations: Pacific Eye Group, PC (Bend, OR) and Charles Sung MD PC (Kennewick, WA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Phan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Phan accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, BridgeSpan Health Company, PacificSource Health Plans and Providence Health Plan and 1 other insurer list Kevin Phan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kevin Phan was last updated on September 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.