Individual provider Active NPI

Long Thanh Nguyen, O.D.

  • Optometrist
  • Burbank, CA
National Provider Identifier
1174993091
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15430 Issued in CA
Practice address
2201 W Olive Ave
Burbank, CA 91506-2625
Phone
(818) 845-3783
Fax
(818) 845-1065
NPI assigned
Oct 5, 2015
Last updated
Jul 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 15430 CA Primary

Addresses

Primary practice location

2201 W Olive Ave
Burbank, CA 91506-2625

Mailing address

2201 W Olive Ave
Burbank, CA 91506-2625
Phone (818) 845-3783

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
I20160125002582 CA Practitioner - Optometry 3072816032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2201 W Olive Ave
Burbank, CA 91506-2625
Phone (818) 845-3783

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McCarthy Optometric Group a Professional Corporation Optometrist CurrentSince Oct 16, 2022 Accepting new patients
M. Trinh Optometry Inc Optometrist CurrentSince Dec 29, 2015 Accepting new patients
Eyecon Optometry Partnership Optometrist CurrentSince Sep 16, 2024 Accepting new patients
New Vision Optometry, Inc. Optometrist CurrentSince Feb 1, 2019 Accepting new patients
Laura K. Ha, O.D. Optometry a Professional Corporation Optometrist CurrentSince Nov 9, 2024 Accepting new patients
Ronald L. Goldstein, O.D. Optometrist PastSince Dec 29, 2015 Accepting new patients

Locations

2201 W Olive Ave
Burbank, CA 91506
Phone (818) 845-3783

99 E Daily Dr
Camarillo, CA 93010
Phone (805) 482-8849

7217 Reseda Blvd
Reseda, CA 91335
Phone (818) 345-2010

277 Hampshire Rd
Westlake Village, CA 91361
Phone (805) 495-4625

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1174993091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 W OLIVE AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062625",
            "telephone_number": "818-845-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 W OLIVE AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062625",
            "telephone_number": "818-845-3783",
            "fax_number": "818-845-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LONG",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-05",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.