Individual provider Active NPI

Vincent Minh DO, O.D.

  • Optometrist
  • Orlando, FL
National Provider Identifier
1366635831
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC#3789 Issued in FL
Practice address
4413 Hoffner Ave
Orlando, FL 32812-2331
Phone
(407) 207-5310
Fax
(407) 792-1324
NPI assigned
Aug 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC#3789 FL Primary

Addresses

Primary practice location

4413 Hoffner Ave
Orlando, FL 32812-2331

Mailing address

4413 Hoffner Ave
Orlando, FL 32812-2331
Phone (407) 207-5310

Other identifiers 1

IdentifierTypeStateIssuer
002289700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100130000139 FL Practitioner - Optometry 7012050073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4413 Hoffner Ave
Belle Isle, FL 32812-2331
Phone (407) 207-5310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC#3789FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DV Eye Center, LLC Optometrist CurrentSince Jul 28, 2010 Accepting new patients

Locations

4413 Hoffner Ave
Orlando, FL 32812
Phone (407) 207-5310

Organizations & group practices 1

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": "1187481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1366635831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 HOFFNER AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328122331",
            "telephone_number": "407-207-5310",
            "fax_number": "407-792-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 HOFFNER AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328122331",
            "telephone_number": "407-207-5310",
            "fax_number": "407-792-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "VINCENT",
        "middle_name": "MINH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-19",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC#3789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002289700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.