Connie Nguyen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T12914 Issued in CA

Practice address

1822 Marron Rd
North County Plaza #100
Carlsbad, CA 92008-1172

Phone

(760) 434-7620

Fax

(760) 434-3069

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1225060742
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Luxottica of America Inc.

  dba Lenscrafters #611

  • Eyewear Supplier
  • Riverside, CA
  • NPI 1366598120
  NPD (past)
• Mika E Fu O D Inc a California Professional Optometric Corporatio

  dba Grand Vision Optometry

  • Optometrist
  • San Marcos, CA
  • NPI 1871746982
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1073666897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 567",
            "city": "RANCHO SANTA FE",
            "state": "CA",
            "postal_code": "920670567",
            "telephone_number": "760-650-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 MARRON RD",
            "address_2": "NORTH COUNTY PLAZA #100",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081172",
            "telephone_number": "760-434-7620",
            "fax_number": "760-434-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CONNIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "T12914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mai Ngo, PHARM D
• Raymond Thanh Ngo
• Valentine Ngo, PT, DPT
• Kayla Nguyen-Galan
• Chau Nguyen, PHARMD
• Dom Dop Van Nguyen, PHARM.D.
• Ha Hoang Nguyen, PHARMD, BCPS
• Lan Nguyen
• Lan Thi My Nguyen
• Luz Nguyen, BT

• Optometrist in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.