Individual provider Active NPI

Kathy Vu, O.D.

  • Optometrist
  • Glendale, AZ
National Provider Identifier
1073778601
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1631 Issued in AZ
Practice address
11851 N 51St Ave
Suite 120
Glendale, AZ 85304-2809
Phone
(623) 414-6476
NPI assigned
Jul 23, 2008
Last updated
Oct 1, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 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 1631 AZ Primary

Addresses

Primary practice location

11851 N 51St Ave
Suite 120
Glendale, AZ 85304-2809

Mailing address

11851 N 51St Ave
Suite 120
Glendale, AZ 85304-2809
Phone (623) 414-6476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20141106000687 AZ Practitioner - Optometry 4183846157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11851 N 51St Ave
BLDG a Suite 120
Glendale, AZ 85304-2830
Phone (623) 414-6476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1631AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kathy Vu Ngo, PLLC Optometrist CurrentSince Jul 8, 2014 Accepting new patients

Locations

11851 N 51st Ave
Ste 120
Glendale, AZ 85304
Phone (623) 414-6476

11851 N 51st Ave
Ste A120
Glendale, AZ 85304
Phone (623) 414-6476

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1073778601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11851 N 51ST AVE",
            "address_2": "SUITE 120",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853042809",
            "telephone_number": "623-414-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11851 N 51ST AVE",
            "address_2": "SUITE 120",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853042809",
            "telephone_number": "623-414-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "KATHY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.