Individual provider Active NPI

Cindy Phuong Nguyen, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1093147613
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14875TLG Issued in CA
Practice address
2980 E Capitol Expy Ste 20
San Jose, CA 95148-4246
Phone
(408) 531-9552
NPI assigned
Aug 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14875TLG CA Primary

Addresses

Primary practice location

2980 E Capitol Expy Ste 20
San Jose, CA 95148-4246

Mailing address

2980 E Capitol Expy Ste 20
San Jose, CA 95148-4246
Phone (408) 531-9552

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
I20160727001021 CA Practitioner - Optometry 7618108432 Practice locations: San Jose, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14875TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyefocus2020, Inc Optometrist CurrentSince Nov 17, 2019 Accepting new patients
Eyesite2020, LLC Optometrist Current Accepting new patients
Total Vision PC Optometrist PastSince Feb 4, 2020 Accepting new patients

Locations

2980 E Capitol Expy
Ste 20
San Jose, CA 95148
Phone (408) 221-8609

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": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1093147613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 E CAPITOL EXPY STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951484246",
            "telephone_number": "408-531-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 E CAPITOL EXPY STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951484246",
            "telephone_number": "408-531-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CINDY",
        "middle_name": "PHUONG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14875TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.