Individual provider Active NPI

Kristy Y-Van Nguyen

  • Optometrist
  • Birmingham, AL
National Provider Identifier
1023630720
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T-245-TA-B75 Issued in AL
Practice address
1716 University Blvd G080A
Birmingham, AL 35294-0010
Phone
(205) 975-2020
Fax
(205) 934-6755
NPI assigned
May 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T-245-TA-B75 AL Primary

Addresses

Primary practice location

1716 University Blvd G080A
Birmingham, AL 35294-0010

Mailing address

1716 University Blvd G080A
Birmingham, AL 35294-0010
Phone (205) 975-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 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
I20200604000088 AL Practitioner - Optometry 7618398348 Reassigns benefits to 1 organization
I20211011000276 MS Practitioner - Optometry 7618398348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brown Eyed Girls PLLCGroup PAC ID 5496105439, 6 clinicians

Practice addresses (Care Compare)

3430 Bienville Blvd
Ocean Springs, MS 39564-5732
Phone (228) 875-3318

506 Larcher Blvd
BLDG 2306
Biloxi, MS 39534-2342
Phone (228) 432-8272

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1027MSMDChiropractor
T-245-TA-B75ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama at Birmingham CurrentSince Jun 22, 2020 Accepting new patients
University of Alabama at Birmingham Current Accepting new patients
Brown Eyed Girls PLLC Optometrist CurrentSince Dec 4, 2023 Accepting new patients
Eaglevue Eye Care LLC Optometrist CurrentSince Apr 8, 2024 Accepting new patients
The University of Alabama at Birmingham Optometrist CurrentSince Jun 22, 2020 Accepting new patients

Locations

1716 University Blvd
Birmingham, AL 35233
Phone (205) 934-3899

1716 University Blvd
#G80A
Birmingham, AL 35233
Phone (205) 934-4748

1716 University Blvd
Birmingham, AL 35294

506 Larcher Blvd
Keesler AFB, MS 39534
Phone (228) 432-8272

2510 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 875-3318

3430 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 875-3318

Networks

  • MS PPO
  • MS PPO D-SNP
  • MS PPO C-SNP

Organizations & group practices 5

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": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1023630720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 UNIVERSITY BLVD G080A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352940010",
            "telephone_number": "205-975-2020",
            "fax_number": "205-934-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 UNIVERSITY BLVD G080A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352940010",
            "telephone_number": "205-975-2020",
            "fax_number": "205-934-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KRISTY",
        "middle_name": "Y-VAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "T-245-TA-B75",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.