Individual provider Active NPI

Kim Nguyen, OD

  • Optometrist
  • Marrero, LA
National Provider Identifier
1003536749
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2012-958AT Issued in LA
Practice address
5572 Avery Dr
Marrero, LA 70072-5138
Phone
(504) 214-1627
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-F05-TA-C64 AL
Optometrist 152W00000X 009630 NY
Optometrist 152W00000X 2012-958AT LA Primary

Addresses

Primary practice location

5572 Avery Dr
Marrero, LA 70072-5138

Mailing address

1111 Medical Center Blvd
Marrero, LA 70072-3151
Phone (504) 347-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230228001710 AL Practitioner - Optometry 5395118004 Reassigns benefits to 1 organization
I20240724000616 LA Practitioner - Optometry 5395118004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heitmeier Physicians Optical 7 clinicians
Heitmeier and Armani Medical and Surgical Eyecare LLC 11 clinicians

Practice addresses (Care Compare)

1111 Medical Ctr Blvd
Suite 111
Marrero, LA 70072-3257
Phone (504) 347-6330

3501 Holiday Dr
Suite 201
New Orleans, LA 70114-8250
Phone (504) 368-7081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-F05-TA-C64ALMDOptometrist
2012-958ATLAMDOptometrist
009630NYMDOptometrist

Practice roles (4 of 21)

OrganizationSpecialtyStatusNew patients
Franklin Primary Health Center, Inc CurrentSince Oct 28, 2022 Accepting new patients
Heitmeier & Armani Medical & Surgical Eyecare LLC Optometrist CurrentSince May 10, 2024 Accepting new patients
Heitmeier Physicians Optical Optometrist CurrentSince May 10, 2024 Accepting new patients
Franklin Primary Health Center Inc. Optometrist CurrentSince Oct 28, 2022 Accepting new patients

Locations

1303 Dr Martin L King Jr Ave
Mobile, AL 36603
Phone (251) 436-7646

1303 Dr Martin L King Jr Ave
#A
Mobile, AL 36603

1111 Medical Center Blvd
Ste N111
Marrero, LA 70072

1111 Medical Center Blvd
Ste 111
Marrero, LA 70072
Phone (504) 347-6330

3501 Holiday Dr
Ste 201
New Orleans, LA 70114
Phone (504) 293-3333

Networks

  • FL HMO D-SNP
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • TX HMO D-SNP
  • MS PPO
  • LA PPO C-SNP
  • MS PPO C-SNP
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • MS PPO D-SNP
  • FL PPO
  • AL HMO
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • AL HMO D-SNP
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • TX HMO
  • TN PPO
  • TN PPO C-SNP

Organizations & group practices 4

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": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1003536749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-347-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5572 AVERY DR",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700725138",
            "telephone_number": "504-214-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-F05-TA-C64",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009630",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "2012-958AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.