Active NPI
Michelle Bao Nguyen, OD
- Optometrist
- Gainesville, FL
National Provider Identifier
1346660032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1962
- Practice address
- 5533 SW 64TH St
Optometry
Gainesville, FL 32608-9608 - Phone
- (352) 271-5967
- NPI assigned
- Apr 21, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1962 | AZ | Primary |
Addresses
Primary practice location
5533 SW 64TH St
Optometry
Gainesville, FL 32608-9608
Mailing address
5533 SW 64TH St
Optometry
Gainesville, FL 32608-9608
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181217001566 | TX | Order and Referring Only - Optometry | 2961747175 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1962 | AZ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398038400000",
"number": "1346660032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5533 SW 64TH ST",
"address_2": "OPTOMETRY",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326089608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5533 SW 64TH ST",
"address_2": "OPTOMETRY",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326089608",
"telephone_number": "352-271-5967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "MICHELLE",
"middle_name": "BAO",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-21",
"last_updated": "2014-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "1962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.