Active NPI
Tammy Nguyen, O.D.
- Optometrist
- San Jose, CA
National Provider Identifier
1053497172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11933T
- Practice address
- 1818 Tully Rd
158B
San Jose, CA 95122-1883 - Phone
- (408) 274-0998
- Fax
- (408) 274-2060
- NPI assigned
- Oct 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11933T | CA | Primary |
Addresses
Primary practice location
1818 Tully Rd
158B
San Jose, CA 95122-1883
Mailing address
3045 Balmoral Dr
San Jose, CA 95132-1704
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14008 | Other | CA | MEDICAL EYE SERVICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11933T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Eyewear Supplier
- Riverside, CA
- NPI 1366598120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053497172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3045 BALMORAL DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951321704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1818 TULLY RD",
"address_2": "158B",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951221883",
"telephone_number": "408-274-0998",
"fax_number": "408-274-2060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "TAMMY",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "11933T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL EYE SERVICE",
"identifier": "14008",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.