Individual provider Active NPI

Anita Nguyen

  • Optometrist
  • Federal Way, WA
National Provider Identifier
1124757257
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61316784 Issued in WA
Practice address
32717 1St Ave S Ste 6
Federal Way, WA 98003-5758
Phone
(253) 838-5428
NPI assigned
Jun 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD61316784 WA Primary

Addresses

Primary practice location

32717 1St Ave S Ste 6
Federal Way, WA 98003-5758

Mailing address

32717 1St Ave S Ste 6
Federal Way, WA 98003-5758
Phone (253) 838-5428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240506000993 WA Practitioner - Optometry 8426498627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brent Chin OD Inc PSGroup PAC ID 7214030097, 3 clinicians

Practice addresses (Care Compare)

32717 1St Ave S
Suite 6
Federal Way, WA 98003-5758
Phone (253) 838-5428

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD61316784WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Family Eye Center, PLLC Optometrist Current Accepting new patients
Brent Chin OD Inc PS Optometrist CurrentSince Mar 26, 2024 Accepting new patients
Federal Way Vision Center Optometrist PastSince Jun 21, 2022 Accepting new patients

Locations

32717 1st Ave S
Ste 6
Federal Way, WA 98003
Phone (253) 838-5428

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": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1124757257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32717 1ST AVE S STE 6",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035758",
            "telephone_number": "253-838-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32717 1ST AVE S STE 6",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035758",
            "telephone_number": "253-838-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2024-06-10",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61316784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.