Huan Viet Pham, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5142 Issued in OH

Practice address

5373 Oberlin Ave
Lorain, OH 44053-3437

Phone

(440) 934-3770

Fax

(866) 423-6354

NPI assigned

Aug 31, 2006

Sex

Male

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 OH

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 and National Provider Directory roles.

• Avon Family Eyecare, LLC

  • Optometrist
  • Lorain, OH
  • NPI 1457563892
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1306957535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5373 OBERLIN AVE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533437",
            "telephone_number": "440-934-3770",
            "fax_number": "866-423-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5373 OBERLIN AVE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533437",
            "telephone_number": "440-934-3770",
            "fax_number": "866-423-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HUAN",
        "middle_name": "VIET",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2226497",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce Allen Petkovsek, RPH
• Gina Petrella, LPCC
• Christopher Petrick
• Chiquitta Petty
• Breyonna Faith Pfeiffer
• Pharmacy Counter LLC
• Phazes LLC
• Christine Ann Phelps, PA
• Courtney M Phillips
• Edward Phillips

• Optometrist in Lorain, OH
• Providers in Lorain, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.