Jackie K Nguyen, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

017896 Issued in ME

Practice address

53 Sewall Street
Portland, ME 04102

Phone

(207) 828-2020

Fax

(207) 773-7034

NPI assigned

May 26, 2006

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 ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Baylor College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecare Medical GroupGroup PAC ID 7517995129, shared by 2 NPIs, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jnguyen@eyecaremed.intellechartdirect.net

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.

• Eyecare Medical Group

  • Ambulatory Surgical Clinic/Center
  • Portland, ME
  • NPI 1376599381
  Medicare reassignment NPD
• Eyecare Medical Group

  • Ophthalmology Physician
  • Portland, ME
  • NPI 1467557280
  Medicare reassignment NPD

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1326094533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 SEWALL STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-828-2020",
            "fax_number": "207-773-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 SEWALL STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-828-2020",
            "fax_number": "207-773-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JACKIE",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ME",
            "license": "017896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433089999",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Ward Newmann, LCSW
• Alan David Newton, DMD
• David Waka Ngala, MD
• David Ndaye Ngandu, MD
• Alfred Ngo-Hamilton, MD
• Janie Dao Nguyen, D.O.
• Sonka T Nguyen
• Lori Nicholas, PMHNP-BC
• Samantha Nicholas, RN
• Jacob Nichols, DMD

• Ophthalmology Physician in Portland, ME
• Providers in Portland, ME by specialty
• Ophthalmology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.