Christina T Phan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA2420 Issued in MD

Practice address

2730 Peachtree Industrial Blvd Ste 206
Duluth, GA 30097-8628

Phone

(404) 721-3268

Fax

(404) 475-4880

NPI assigned

Aug 11, 2014

Last updated

Jan 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Southern California College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision OnsiteGroup PAC ID 7517495625, 4 clinicians

First Class Eye Care LLCGroup PAC ID 0547680597, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• First Class Eye Care, LLC

  dba First Class Eye Care

  • Optometrist
  • Duluth, GA
  • NPI 1831703289
  Medicare reassignment Care Compare group NPD
• Vision Onsite

  • Optometrist
  • Acworth, GA
  • NPI 1962238931
  Medicare reassignment Care Compare group NPD
• Madaris and Bush Audiology LLC

  • Audiologist
  • Macon, GA
  • NPI 1225780836
  NPD
• Madaris and Herron Vision LLC

  • Optometrist
  • Macon, GA
  • NPI 1740931575
  NPD
• Eyecontact Inc.

  • Optometrist
  • Acworth, GA
  • NPI 1407054232
  NPD (past)
• Aspen Hill Optometry, LLC

  dba My Eye Dr

  • Optometrist
  • Aspen Hill, MD
  • NPI 1629293170
  NPD (past)

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1023427432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 PEACHTREE INDUSTRIAL BLVD STE 206",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 PEACHTREE INDUSTRIAL BLVD STE 206",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978628",
            "telephone_number": "404-721-3268",
            "fax_number": "404-475-4880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13531 Connecticut Ave",
            "address_purpose": "LOCATION",
            "city": "Aspen Hill",
            "state": "MD",
            "postal_code": "209062912",
            "country_code": "US",
            "telephone_number": "301-438-0555",
            "fax_number": "301-438-0556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "CHRISTINA",
        "middle_name": "T",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003276",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petrichor Counseling, LLC
• Teresa Marie Petros, MD
• Hannah Petty, BASW, RBT
• Kaylin Grace Pfitzer, SLP
• Truc Pham, RN
• Felicia D Pharagood Wade, MD
• David Blake Pharis, MD
• Roshaundra C Phifer, NP
• Chontasia Phillips
• Joel Kent Phillips, PA

• Optometrist in Duluth, GA
• Providers in Duluth, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.