Individual provider Active NPI

Xuan Thanh Thi Pham, O.D.

  • Optometrist
  • Dublin, OH
National Provider Identifier
1134421035
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5970 Issued in OH
Practice address
5053 Tuttle Crossing Blvd
Dublin, OH 43016-1533
Phone
(614) 760-5737
NPI assigned
Nov 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5970 OH Primary

Addresses

Primary practice location

5053 Tuttle Crossing Blvd
Dublin, OH 43016-1533

Mailing address

6899 Lakebrook Blvd
Columbus, OH 43235-2724
Phone (602) 206-1580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20131029001970 OH Practitioner - Optometry 5698900629 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newark Vision Care LLCGroup PAC ID 8022420884, 4 clinicians

Practice addresses (Care Compare)

391 Lincoln Park Dr
New Lexington, OH 43764-1080
Phone (740) 342-1784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5970OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Stephanie McDonald OD LLC Optometrist CurrentSince Dec 1, 2023 Accepting new patients
Newark Vision Care LLC Optometrist CurrentSince Sep 13, 2021 Accepting new patients
Mount Vernon Eye Care Optometrist Past Accepting new patients
Robert J. Dittoe, O.D., Inc. Optometrist Past Accepting new patients

Locations

391 Lincoln Park Dr
New Lexington, OH 43764
Phone (740) 342-1784

7 Commercial Ave
Wshngtn Ct Hs, OH 43160
Phone (740) 335-1181

Organizations & group practices 5

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": "1290816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1134421035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6899 LAKEBROOK BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432352724",
            "telephone_number": "602-206-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5053 TUTTLE CROSSING BLVD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430161533",
            "telephone_number": "614-760-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "XUAN",
        "middle_name": "THANH THI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-27",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.