Phuong Le Ai Duong, OPTOMETRIST (O.D.)

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

CA 12716 T Issued in CA

Practice address

1811 Hillsdale Ave
San Jose, CA 95124-3027

Phone

(408) 269-1267

Fax

(408) 269-1265

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Optometry

Education

Southern California College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• Better Image Optometry Inc

  • Optometrist
  • San Jose, CA
  • NPI 1568027449
  NPD Authorized official
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Han Duong Optometry, Inc

  • Optometrist
  • San Jose, CA
  • NPI 1598118325
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154435048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 BLOSSOM HILL RD STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233056",
            "telephone_number": "408-300-0717",
            "fax_number": "888-604-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 HILLSDALE AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243027",
            "telephone_number": "408-269-1267",
            "fax_number": "408-269-1265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7150 Camino Arroyo",
            "address_purpose": "LOCATION",
            "city": "Gilroy",
            "state": "CA",
            "postal_code": "950207347",
            "country_code": "US",
            "telephone_number": "408-848-1865",
            "fax_number": "408-848-5666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "630 Blossom Hill Rd Ste 20",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951233056",
            "country_code": "US",
            "telephone_number": "408-300-0717",
            "fax_number": "888-604-2519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUONG",
        "first_name": "PHUONG",
        "middle_name": "LE AI",
        "credential": "OPTOMETRIST (O.D.)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "CA 12716 T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "12716",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5755 Cottle Rd",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michell M Duong, PHARM. D
• Minh Chau Duong
• Nghia Duong
• Nghia Trong Duong
• Pamela Duong
• Quyen Thuc Duong, D.D.S.
• Thanhmai Duong, MD
• Thao Thi Thu Duong, MD
• Tra Van Duong
• Trang Duong, DMD

• Low Vision Rehabilitation Optometrist in San Jose, CA
• Providers in San Jose, CA by specialty
• Low Vision Rehabilitation Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.