Kim Ngan Thi Pham, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 4926 Issued in FL

Practice address

2655 Gulf to Bay Blvd
Phamily Eye Care Optical
Clearwater, FL 33759

Phone

(727) 373-1954

NPI assigned

Jun 22, 2014

Last updated

Dec 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eye Doctors Optical Outlets PA

  • Optometrist
  • Orlando, FL
  • NPI 1164308771
  Medicare reassignment NPD
• Phamily Eye Care, LLC

  • Optometrist
  • Clearwater, FL
  • NPI 1922876978
  NPD (past) Authorized official
• Eye Doctors Optical Outlets PA

  • Optometrist
  • Tampa, FL
  • NPI 1114012689
  NPD

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

{
    "created_epoch": "1403395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1255746947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 GULF TO BAY BLVD",
            "address_2": "PHAMILY EYE CARE OPTICAL",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33759",
            "telephone_number": "727-373-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 GULF TO BAY BLVD",
            "address_2": "PHAMILY EYE CARE OPTICAL",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33759",
            "telephone_number": "727-373-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KIM",
        "middle_name": "NGAN THI",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-22",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12717067",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Petro, O.D.
• Samantha Petroshius-Crocker, LMHC
• Glen C Pettersen, DC
• Christopher Edwin Pettet, D.C.
• Sirrenna Petty
• Nguyen Pham, DMD
• Phamily Eye Care, LLC
• Pharmacy Benefit Solutions LLC
• Pharmadvice, Inc. (Pharmacy Express & Medical Supplies)
• Pharmedix LLC

• Optometrist in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.