Individual provider Active NPI

Nguyen Tran

  • Optometrist
  • Newington, CT
National Provider Identifier
1083259428
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3136 Issued in CT
Practice address
262 Brockett St
Newington, CT 06111
Phone
(860) 667-2020
Fax
(860) 667-0770
NPI assigned
Nov 8, 2019
Last updated
Apr 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3136 CT Primary

Addresses

Primary practice location

262 Brockett St
Newington, CT 06111

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200205001502 CT Practitioner - Optometry 3971939281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1457 Whalley Ave
New Haven, CT 06515-1153
Phone (203) 387-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3136CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Connecticut, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Dec 16, 2019 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Dec 16, 2019 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist Past Accepting new patients

Locations

145 Wakelee Ave
Ansonia, CT 06401
Phone (203) 734-1686

1457 Whalley Ave
New Haven, CT 06515
Phone (203) 387-3937

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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, 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": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1083259428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 BROCKETT ST",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "06111",
            "telephone_number": "860-667-2020",
            "fax_number": "860-667-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "NGUYEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-08",
        "last_updated": "2022-04-07",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

Verify at the official NPI Registry.