Active NPI
Dan Phuong T Nguyen, O.D
- Optometrist
- Dorchester, MA
National Provider Identifier
1245692722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT5137
- Practice address
- 2110 Dorchester Ave
Suite 306
Dorchester, MA 02124-5628 - Phone
- (617) 296-1828
- NPI assigned
- Mar 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT5137 | MA | Primary |
Addresses
Primary practice location
2110 Dorchester Ave
Suite 306
Dorchester, MA 02124-5628
Mailing address
637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660
Other practice location 1
637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110128327A | Medicaid | MA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660
Hospital & facility affiliations
- Boston Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT5137 | MA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Codman Square Health Center Inc | Current | Accepting new patients | |
| Eye Services Consultants Inc PC | Past | Accepting new patients |
Locations
637 Washington St
Dorchestr Ctr, MA 02124
Phone (617) 822-8211
Interoperability endpoints
- dnguyen615370@direct.ochin.org
- dnguyen181728@direct.bmc.masshiway.net
- dnguyen189958@direct.ochin.org
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 and National Provider Directory roles.
-
- Community Health Clinic/Center
- Dorchester Center, MA
- NPI 1396808309
-
- Ophthalmology Physician
- Dorchester, MA
- NPI 1225180797
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1164177028
-
- Community Health Clinic/Center
- South Boston, MA
- NPI 1225228679
Hospital
-
- General Acute Care Hospital
- Boston, MA
- NPI 1346218294
-
- Community Health Clinic/Center
- Roslindale, MA
- NPI 1386718823
Hospital
-
- Community Health Clinic/Center
- Dorchester, MA
- NPI 1780874677
Hospital
-
- Community Health Clinic/Center
- East Boston, MA
- NPI 1861683518
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702252800000",
"number": "1245692722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "637 WASHINGTON ST",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021243510",
"telephone_number": "617-825-9660",
"fax_number": "617-288-7898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 DORCHESTER AVE",
"address_2": "SUITE 306",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021245628",
"telephone_number": "617-296-1828"
}
],
"practiceLocations": [
{
"address_1": "637 Washington St",
"address_purpose": "LOCATION",
"city": "Dorchester",
"state": "MA",
"postal_code": "021243510",
"country_code": "US",
"telephone_number": "617-825-9660",
"fax_number": "617-288-7898",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "DAN PHUONG",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-24",
"last_updated": "2023-12-11",
"certification_date": "2023-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "OPT5137",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110128327A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.