Individual provider Active NPI

Vivien Le Pham, OD

  • Optometrist
  • Kansas City, MO
National Provider Identifier
1366339079
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2025023990 Issued in MO
Practice address
9596 N McGee St
Kansas City, MO 64155-8103
Phone
(816) 476-4017
NPI assigned
Jun 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 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 2025023990 MO Primary

Addresses

Primary practice location

9596 N McGee St
Kansas City, MO 64155-8103

Mailing address

5054 Canterbury Rd
Roeland Park, KS 66205-1621

Other practice location 1

2100 E Mechanic St
Harrisonville, MO 64701-2057
Phone (816) 884-5212

Other practice location 2

19045 E Valley View Pkwy Ste A
Independence, MO 64055-7030
Phone (816) 795-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20250910002434 MO Practitioner - Optometry 3375046048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Eyecare Specialties IncGroup PAC ID 1153371646, 15 clinicians

Practice addresses (Care Compare)

9596 N McGee St
Kansas City, MO 64155-8103
Phone (816) 476-4017

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025023990MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Eyecare Specialties Inc. Optometrist CurrentSince Sep 1, 2025 Accepting new patients
Insight Eyecare Specialties Inc Optometrist CurrentSince Sep 1, 2025 Accepting new patients
Insight Eyecare Specialties Inc Optometrist Past Accepting new patients

Locations

2100 E Mechanic St
Harrisonville, MO 64701
Phone (816) 795-7777

19045 E Valley View Pkwy
Independence, MO 64055
Phone (816) 254-2345

19045 E Valley View Pkwy
Ste A
Independence, MO 64055
Phone (816) 795-7777

9596 N McGee St
Kansas City, MO 64155
Phone (816) 476-4017

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1366339079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5054 CANTERBURY RD",
            "city": "ROELAND PARK",
            "state": "KS",
            "postal_code": "662051621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9596 N MCGEE ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641558103",
            "telephone_number": "816-476-4017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 E Mechanic St",
            "address_purpose": "LOCATION",
            "city": "Harrisonville",
            "state": "MO",
            "postal_code": "647012057",
            "country_code": "US",
            "telephone_number": "816-884-5212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19045 E Valley View Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640557030",
            "country_code": "US",
            "telephone_number": "816-795-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "VIVIEN",
        "middle_name": "LE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2025023990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.