Individual provider Active NPI

Kaitlyn Thi Nguyen

  • Optometrist
  • Rockwall, TX
National Provider Identifier
1316834484
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11455 Issued in TX
Practice address
1225 State Highway 276
Rockwall, TX 75032-9376
Phone
(972) 772-1613
NPI assigned
Jun 21, 2025
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 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 11455 TX Primary

Addresses

Primary practice location

1225 State Highway 276
Rockwall, TX 75032-9376

Mailing address

3301 College Ave
Davie, FL 33314-7721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250820000868 TX Practitioner - Optometry 5193224798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunny M. Field, O.D., F.a.a.O., PAGroup PAC ID 8729200639, 2 clinicians

Practice addresses (Care Compare)

1225 State Hwy 276
Rockwall, TX 75032-9376
Phone (972) 772-1613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11455TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sunny M. Field, O.D., F.a.a.O., P.a. Optometrist CurrentSince Jul 29, 2025 Accepting new patients

Locations

1225 State Highway 276
Rockwall, TX 75032
Phone (972) 772-1609

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": "1750464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1316834484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 COLLEGE AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333147721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 STATE HIGHWAY 276",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750329376",
            "telephone_number": "972-772-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KAITLYN",
        "middle_name": "THI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-21",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.