Individual provider Active NPI

Man Tri Vu, OD

  • Pediatric Optometrist
  • Warminster, PA
National Provider Identifier
1275687907
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
OEG001215 Issued in PA
Practice address
632 York Rd
Warminster, PA 18974-2002
Phone
(215) 830-9787
Fax
(215) 830-9783
NPI assigned
Jan 22, 2007
Last updated
Jul 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X OEG001215 PA Primary

Addresses

Primary practice location

632 York Rd
Warminster, PA 18974-2002

Mailing address

303 E Cheltenham Ave
Philadelphia, PA 19120-1602
Phone (215) 830-9787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040405000401 PA Practitioner - Optometry 0941293260 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Vision Center Inc Pediatrics CurrentSince Mar 2, 2020 Accepting new patients

Locations

2838 Street Rd
Bensalem, PA 19020
Phone (215) 244-2020

Organizations & group practices 1

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1275687907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E CHELTENHAM AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191201602",
            "telephone_number": "215-830-9787",
            "fax_number": "215-830-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 YORK RD",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189742002",
            "telephone_number": "215-830-9787",
            "fax_number": "215-830-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "MAN",
        "middle_name": "TRI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "PA",
            "license": "OEG001215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warminster, PA

Sources for this page

Verify at the official NPI Registry.