Individual provider Active NPI

Jenny Au Nguyen

  • Optometrist
  • Waipahu, HI
National Provider Identifier
1255079166
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD-987 Issued in HI
Practice address
94-050 Farrington Hwy Ste B1-1
Waipahu, HI 96797-1800
Phone
(808) 677-1544
Fax
(808) 671-3538
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD-987 HI Primary

Addresses

Primary practice location

94-050 Farrington Hwy Ste B1-1
Waipahu, HI 96797-1800

Mailing address

94-050 Farrington Hwy Ste B1-1
Waipahu, HI 96797-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20220815003258 HI Practitioner - Optometry 4486037017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Care Center of Hawaii LLCGroup PAC ID 2062802044, 5 clinicians

Practice addresses (Care Compare)

94-050 Farrington Hwy
Suite B1 1
Waipahu, HI 96797-1800
Phone (808) 677-1544

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD-987HIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmology Consultants of Oahu, a Professional Corporation Optometrist CurrentSince Sep 1, 2022 Accepting new patients
Vision Care Center of Hawaii LLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Ophthalmology Consultants of Oahu LLC CurrentSince Sep 1, 2022 Accepting new patients
Roger Christian Ede, O.D., Inc. Optometrist PastSince Oct 1, 2024 Accepting new patients

Locations

6600 Kalanianaole Hwy
Ste 114C
Honolulu, HI 96825
Phone (808) 373-9373

94-050 Farrington Hwy
Ste B1-1
Waipahu, HI 96797
Phone (808) 677-1544

94-050 Farrington Hwy
Ste B11
Waipahu, HI 96797
Phone (808) 677-1544

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1255079166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-050 FARRINGTON HWY STE B1-1",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967971800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-050 FARRINGTON HWY STE B1-1",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967971800",
            "telephone_number": "808-677-1544",
            "fax_number": "808-671-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JENNY",
        "middle_name": "AU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD-987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

Verify at the official NPI Registry.