Individual provider Active NPI

Linh Nguyen Bui, OD

  • Optometrist
  • Fort Wayne, IN
National Provider Identifier
1326629114
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004484A Issued in IN
Practice address
3401 Lake Ave
Fort Wayne, IN 46805-5500
Phone
(260) 426-3095
Fax
(260) 420-2258
NPI assigned
Apr 14, 2021
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-E74-TA-C20 AL
Optometrist 152W00000X 18004484A IN Primary

Addresses

Primary practice location

3401 Lake Ave
Fort Wayne, IN 46805-5500

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210616001518 AL Practitioner - Optometry 4880094689 Reassigns benefits to 1 organization
I20240806002720 IN Practitioner - Optometry 4880094689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-E74-TA-C20ALMDOptometrist
18004484AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Indiana, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Alabama, LLC Optometrist CurrentSince Jun 7, 2021 Accepting new patients
Myeyedr Optometry of Alabama LLC Optometrist CurrentSince Jun 7, 2021 Accepting new patients
Myeyedr Optometry of Alabama LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Myeyedr Optometry of Indiana, LLC Optometrist CurrentSince Jul 1, 2024 Accepting new patients

Locations

3431 Colonnade Pkwy
Ste 100
Birmingham, AL 35243
Phone (205) 967-2020

195 Highway 304
Calera, AL 35040
Phone (205) 668-7920

2737 Highway 280 S
Ste 191
Mountain Brk, AL 35223
Phone (205) 802-2020

9760 Lantern Rd
Fishers, IN 46037
Phone (317) 577-9200

3401 Lake Ave
Fort Wayne, IN 46805
Phone (260) 422-6396

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 6

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": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1326629114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055500",
            "telephone_number": "260-426-3095",
            "fax_number": "260-420-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUI",
        "first_name": "LINH",
        "middle_name": "NGUYEN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E74-TA-C20",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004484A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.