Individual provider Active NPI

Phuong T.C Le, O.D

  • Optometrist
  • Westminster, CA
National Provider Identifier
1356532600
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13375 Issued in CA
Practice address
9600 Bolsa Ave
Suite C and H
Westminster, CA 92683-5949
Phone
(714) 775-7045
NPI assigned
Aug 1, 2007
Last updated
Feb 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2536 OK
Optometrist 152W00000X 13375 CA Primary

Addresses

Primary practice location

9600 Bolsa Ave
Suite C and H
Westminster, CA 92683-5949

Mailing address

9600 Bolsa Ave Ste C&H
Westminster, CA 92683-5949
Phone (714) 775-7045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090911000223 CA Practitioner - Optometry 7810084225 Reassigns benefits to 1 organization
Practice locations: Westminster, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9600 Bolsa Ave
Suite C
Westminster, CA 92683-5949
Phone (714) 775-7045

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2536OKMDPhysical Therapist
13375CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Optometry Group, PC Optometrist CurrentSince Jul 1, 2021 Accepting new patients
Horizon Optometry Vision Center, PC Optometrist CurrentSince Oct 5, 2021 Accepting new patients
Cherokee Nation Past Accepting new patients
Cherokee Nation PastSince Mar 1, 2021 Accepting new patients
Northeastern State University College of Optometry Optometrist PastSince Jul 1, 2025 Accepting new patients

Locations

14361 Beach Blvd
Ste 201
Westminster, CA 92683
Phone (714) 684-1711

9600 Bolsa Ave
Ste C
Westminster, CA 92683
Phone (714) 234-7021

9600 Bolsa Ave
Ste Ch
Westminster, CA 92683
Phone (714) 775-7045

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/

Organizations & group practices 5

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": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1356532600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 BOLSA AVE STE C&H",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835949",
            "telephone_number": "714-775-7045",
            "fax_number": "714-775-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BOLSA AVE",
            "address_2": "SUITE C AND H",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835949",
            "telephone_number": "714-775-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "PHUONG",
        "middle_name": "T.C",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2536",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.