Peter Tien Dzung Pham, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002204 Issued in VA

Practice address

14044 Promenade Commons St
Gainesville, VA 20155-4072

Phone

(850) 384-1554

NPI assigned

Feb 13, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Optometry

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr Peter T Pham & Associates

  • Optometrist
  • Manassas, VA
  • NPI 1689090771
  Medicare reassignment NPD Authorized official
• Peter T Pham OD, PLLC

  • Optometrist
  • Gainesville, VA
  • NPI 1457801854
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1003155946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11024 OAKTON VIEW DR",
            "city": "OAKTON",
            "state": "VA",
            "postal_code": "221242439",
            "telephone_number": "850-384-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14044 PROMENADE COMMONS ST",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554072",
            "telephone_number": "850-384-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "PETER",
        "middle_name": "TIEN DZUNG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-13",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Performance Care Corporation
• Perioworks LLC
• Shabaan Pervaiz, DDS
• Zan Pervaiz, DDS
• Peter T Pham OD, PLLC
• VI Phan
• Pharmasutra PLLC
• David Randell Phelps, APRN
• Phoenix Counselinggroup and Play Therapycenter, PLLC
• Phoenix Family Counseling & Play Therapy Center, PLLC

• Optometrist in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.

Verify at the official NPI Registry.