Individual provider Active NPI

Trang Van Nguyen, O.D.

  • Optometrist
  • Santa Monica, CA
National Provider Identifier
1083685390
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MN1220552 Issued in CA
Practice address
2901 Wilshire Blvd
Suite 100
Santa Monica, CA 90403-4901
Phone
(310) 449-0066
Fax
(310) 453-2971
NPI assigned
Jan 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MN1220552 CA Primary

Addresses

Primary practice location

2901 Wilshire Blvd
Suite 100
Santa Monica, CA 90403-4901

Mailing address

2901 Wilshire Blvd
Suite 100
Santa Monica, CA 90403-4901
Phone (310) 449-0066

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
I20080328000242 CA Practitioner - Optometry 1254417462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2901 Wilshire Blvd
Suite 100
Santa Monica, CA 90403-4915
Phone (310) 449-0066

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10389CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nguyen Family Vision Care Optometry Corporation Optometrist CurrentSince Mar 9, 2020 Accepting new patients
The Center for the Partially Sighted Optometrist Past Accepting new patients

Locations

2901 Wilshire Blvd
Ste 100
Santa Monica, CA 90403
Phone (310) 315-1936

Organizations & group practices 2

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1083685390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 WILSHIRE BLVD",
            "address_2": "SUITE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034901",
            "telephone_number": "310-449-0066",
            "fax_number": "310-453-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 WILSHIRE BLVD",
            "address_2": "SUITE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034901",
            "telephone_number": "310-449-0066",
            "fax_number": "310-453-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRANG",
        "middle_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "MN1220552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.