Individual provider Active NPI

Ngoc-Thuy Trina Nguyen, O.D.

  • Optometrist
  • Garden Grove, CA
National Provider Identifier
1063579688
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9686T Issued in CA
Practice address
10872 Westminster Ave
Ste 112
Garden Grove, CA 92843-4981
Phone
(714) 636-9585
Fax
(714) 636-2465
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9686T CA Primary

Addresses

Primary practice location

10872 Westminster Ave
Ste 112
Garden Grove, CA 92843-4981

Mailing address

20470 Via Celestina
Yorba Linda, CA 92887-3145
Phone (714) 693-1733

Other identifiers 6

IdentifierTypeStateIssuer
167250OtherCAHIGH MARK
SD0096861MedicaidCA
114158OtherCAEYE MED
12374OtherCAMEDICAL EYE SERVICES
07626OtherCASPECTERA
35995OtherCADAVIS VISION

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
I20111205000049 CA Practitioner - Optometry 7012182991 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9686TCAMDOptometrist
9686CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vanna Hoang OD Inc Optometrist PastSince Sep 17, 2011 Accepting new patients
Iexam Optometry, PC Optometrist PastSince Jun 24, 2016 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1063579688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20470 VIA CELESTINA",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928873145",
            "telephone_number": "714-693-1733",
            "fax_number": "714-693-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10872 WESTMINSTER AVE",
            "address_2": "STE 112",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434981",
            "telephone_number": "714-636-9585",
            "fax_number": "714-636-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NGOC-THUY",
        "middle_name": "TRINA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9686T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGH MARK",
            "identifier": "167250",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0096861",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "114158",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICES",
            "identifier": "12374",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "07626",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "35995",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.