Individual provider Active NPI

Alice P Nguyen, O.D.

  • Optometrist
  • Federal Way, WA
National Provider Identifier
1215137732
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
60063073 Issued in WA
Practice address
1701 S Commons
Federal Way, WA 98003-6037
Phone
(253) 941-4980
NPI assigned
Jul 23, 2007
Last updated
Dec 22, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0067FCOtherTXBLUE 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

LicenseStateTypeSpecialty
5096TTXMDOptometrist
60063073WAMDOptometrist
10774CAMDPediatric 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.

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.

Verify at the official NPI Registry.