Individual provider Active NPI

Jenny My Linh Nguyen, OD

  • Optometrist
  • Mansfield, TX
National Provider Identifier
1235876582
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10274 Issued in TX
Practice address
1650 Highway 287 N
Mansfield, TX 76063-8852
Phone
(682) 518-1177
Fax
(682) 518-8889
NPI assigned
May 18, 2022
Last updated
May 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 10274 TX Primary

Addresses

Primary practice location

1650 Highway 287 N
Mansfield, TX 76063-8852

Mailing address

716 Willington Dr
Arlington, TX 76018-5113
Phone (817) 917-8430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220705002770 TX Practitioner - Optometry 4385024637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midlothian Vision Associates PLLCGroup PAC ID 3971842683, 5 clinicians

Practice addresses (Care Compare)

1669 S 9TH St
Suite 200
Midlothian, TX 76065-3754
Phone (972) 775-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10274TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midlothian Vision Associates, PLLC Optometrist CurrentSince Jun 1, 2022 Accepting new patients

Locations

1650 Highway 287 N
Mansfield, TX 76063
Phone (682) 518-1177

1669 S 9th St
Midlothian, TX 76065

1669 S 9th St
Ste 200
Midlothian, TX 76065
Phone (972) 775-4040

Organizations & group practices 2

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": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1235876582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 WILLINGTON DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760185113",
            "telephone_number": "817-917-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 HIGHWAY 287 N",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638852",
            "telephone_number": "682-518-1177",
            "fax_number": "682-518-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JENNY",
        "middle_name": "MY LINH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.