Individual provider Active NPI

Kent Nguyen, O.D.

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1255773263
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14391 Issued in CA
Practice address
1450 San Pablo St
4TH Floor
Los Angeles, CA 90033-4500
Phone
(323) 865-6837
NPI assigned
Jul 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14391 CA Primary

Addresses

Primary practice location

1450 San Pablo St
4TH Floor
Los Angeles, CA 90033-4500

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-6335

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kent.nguyen@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20161027002567 CA Practitioner - Optometry 3173801099 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Sep 12, 2016 Accepting new patients
Usc Care Medical Group, Inc Optometrist CurrentSince Sep 12, 2016 Accepting new patients

Locations

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

835 W Jefferson Blvd
Ste 1720
Los Angeles, CA 90089
Phone (213) 740-6960

1450 San Pablo St
Fl 4
Los Angeles, CA 90033
Phone (323) 442-6335

Interoperability endpoints

  • Direct secure messaging: kent.nguyen@direct.usc.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1255773263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST",
            "address_2": "4TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900334500",
            "telephone_number": "323-865-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-19",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kent.nguyen@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1450 San Pablo St",
            "address_2": "4th Floor",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900334500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.