Individual provider Active NPI

Phuong Thanh Nguyen, O.D.

  • Optometrist
  • Quincy, MA
National Provider Identifier
1164855698
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4990 Issued in MA
Practice address
212 Common St
Quincy, MA 02169-4709
Phone
(617) 858-4420
NPI assigned
Aug 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4990 MA Primary

Addresses

Primary practice location

212 Common St
Quincy, MA 02169-4709

Mailing address

212 Common St
Quincy, MA 02169-4709
Phone (617) 858-4420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20140117001654 MA Practitioner - Optometry 5991933004 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uphams Corner Health Committee IncGroup PAC ID 4284645086, 26 clinicians

Practice addresses (Care Compare)

415 Columbia Rd
Dorchester, MA 02125-2424
Phone (617) 287-8000

500 Columbia Rd
Dorchester, MA 02125-2322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4990MAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upham'S Corner Health Committee, Inc. CurrentSince Nov 3, 2022 Accepting new patients
Denise K Snow Williams OD PC Optometrist CurrentSince Jul 1, 2018 Accepting new patients
Comfort Vision Inc Optometrist CurrentSince Jun 1, 2015 Accepting new patients
TPB Enterprises, Inc Optometrist CurrentSince Jun 1, 2015 Accepting new patients
Eye See Eye, LLC Optometrist Current Accepting new patients

Locations

545 Union Ave
Unit A
Framingham, MA 01702
Phone (508) 875-9636

543 Washington St
Quincy, MA 02169
Phone (617) 657-0205

60 Quincy Shore Dr
#A
Quincy, MA 02171
Phone (617) 302-3644

9 Warren St
Randolph, MA 02368
Phone (781) 963-8448

415 Columbia Rd
Uphams Corner, MA 02125
Phone (617) 287-8000

500 Columbia Rd
Uphams Corner, MA 02125
Phone (617) 287-8000

Interoperability endpoints

  • Direct secure messaging: pnguyen310852@direct.ochin.org

Organizations & group practices 6

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": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1164855698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 COMMON ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694709",
            "telephone_number": "617-858-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 COMMON ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694709",
            "telephone_number": "617-858-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUONG",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.