Individual provider Active NPI

Lethuy T Nguyen, O.D.

  • Optometrist
  • Upland, CA
National Provider Identifier
1033285689
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9953 Issued in CA
Practice address
553 N Mountain Ave
Upland, CA 91786-5016
Phone
(909) 985-2876
Fax
(909) 946-8585
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9953 CA Primary

Addresses

Primary practice location

553 N Mountain Ave
Upland, CA 91786-5016

Mailing address

553 N Mountain Ave
Upland, CA 91786-5016
Phone (909) 985-2876

Other identifiers 1

IdentifierTypeStateIssuer
SD0099530MedicaidCA

Other names 1

  • Tanya Nguyen Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20081111000783 CA Practitioner - Optometry 9830258409 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

27001 Moulton Pkwy
Suite A100
Aliso Viejo, CA 92656-3626
Phone (949) 362-6552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McLaurin-Giampiccolo Partnership Optometrist CurrentSince Apr 15, 2015 Accepting new patients
Tanya Optometry Corporation Optometrist CurrentSince Apr 15, 2015 Accepting new patients
Mintz Family Optometry, Apc Optometrist PastSince Sep 10, 2012 Accepting new patients

Locations

27001 Moulton Pkwy
Ste A100
Aliso Viejo, CA 92656
Phone (949) 362-6552

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1033285689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865016",
            "telephone_number": "909-985-2876",
            "fax_number": "909-946-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865016",
            "telephone_number": "909-985-2876",
            "fax_number": "909-946-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LETHUY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0099530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANYA",
            "last_name": "NGUYEN",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.