Individual provider Active NPI

Khanh D Bui, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1154416493
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9892T Issued in CA
Practice address
1013 E Capitol Expy
San Jose, CA 95121-2415
Phone
(408) 281-1311
Fax
(408) 281-1331
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 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 9892T CA Primary

Addresses

Primary practice location

1013 E Capitol Expy
San Jose, CA 95121-2415

Mailing address

1013 E Capitol Expy
San Jose, CA 95121-2415
Phone (408) 281-1311

Other identifiers 1

IdentifierTypeStateIssuer
SD0098920MedicaidCA

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
I20090717000500 CA Practitioner - Optometry 7719881465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1013 E Capitol Expy
San Jose, CA 95121-2415
Phone (408) 281-1311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9892TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Khanh Bui, O.D., P.C. Optometrist CurrentSince Nov 9, 2010 Accepting new patients
DRS. Bui & Le Optometry Professional Corporation Optometrist Past Accepting new patients

Locations

1013 E Capitol Expy
San Jose, CA 95121
Phone (408) 281-1311

2722 Aborn Rd
San Jose, CA 95121
Phone (408) 223-2020

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1154416493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 E CAPITOL EXPY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951212415",
            "telephone_number": "408-281-1311",
            "fax_number": "408-281-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 E CAPITOL EXPY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951212415",
            "telephone_number": "408-281-1311",
            "fax_number": "408-281-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUI",
        "first_name": "KHANH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9892T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0098920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.