Active NPI
Alice P Nguyen, O.D.
- Optometrist
- Federal Way, WA
National Provider Identifier
1215137732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 60063073
- Practice address
- 1701 S Commons
Federal Way, WA 98003-6037 - Phone
- (253) 941-4980
- NPI assigned
- Jul 23, 2007
- Last updated
- Dec 22, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5096T | TX | |
| Optometrist | 152W00000X | 10774 | CA | |
| Optometrist | 152W00000X | 60063073 | WA | Primary |
Addresses
Primary practice location
1701 S Commons
Federal Way, WA 98003-6037
Mailing address
1215 Dexter Ave N Apt 835
Seattle, WA 98109-3575
Phone (832) 260-6468
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0067FC | Other | TX | BLUE CROSS/ BLUE SHIELDS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5096T | TX | MD | Optometrist |
| 60063073 | WA | MD | Optometrist |
| 10774 | CA | MD | Pediatric Occupational Therapist |
Organizations & group practices 1
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.
-
- Optometrist
- Federal Way, WA
- NPI 1982934634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261440000000",
"number": "1215137732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 DEXTER AVE N APT 835",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981093575",
"telephone_number": "832-260-6468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 S COMMONS",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980036037",
"telephone_number": "253-941-4980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "ALICE",
"middle_name": "P",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-23",
"last_updated": "2009-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "5096T",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "10774",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "60063073",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/ BLUE SHIELDS",
"identifier": "0067FC",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.