Teresa Diemtu Pham, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002984 Issued in VA

Practice address

14465 Potomac Mills Rd
Woodbridge, VA 22192-6807

Phone

(703) 494-6184

Fax

(703) 499-9744

NPI assigned

Feb 12, 2007

Last updated

Jan 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NY, FL, VA, WI, MA, MI, CO, AR, DC10 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 10

Specialty

Optometry

Education

Pacific University - College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Massachusetts P CGroup PAC ID 1951661297, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 45)

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.

• Myeyedr Optometry of Massachusetts P C

  dba MyEyeDr.

  • Optometrist
  • Amherst, MA
  • NPI 1124534946
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Virginia PLLC

  dba MyEyeDr

  • Optometrist
  • Ashburn, VA
  • NPI 1174933691
  Medicare reassignment NPD
• CVG Optometry, LLC

  • Optometrist
  • Rochester, NY
  • NPI 1194959486
  Medicare reassignment NPD
• Empire Vision Center Inc

  dba Davis Vision

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• Med Southwest, PLLC

  dba MyEyeDr.

  • Optometrist
  • Arkadelphia, AR
  • NPI 1497211783
  Medicare reassignment NPD
• Myeyedr Optometry of Colorado PC

  dba MyEyeDr.

  • Optometrist
  • Parker, CO
  • NPI 1174170526
  Medicare reassignment NPD
• Myeyedr Optometry of Florida, LLC

  dba MyEyeDr.

  • Optometrist
  • Tallahassee, FL
  • NPI 1073907028
  Medicare reassignment NPD
• Myeyedr Optometry of Michigan, LLC

  dba MyEyeDr.

  • Optometrist
  • Shelby Township, MI
  • NPI 1639723596
  Medicare reassignment NPD
• Myeyedr Optometry of Wisconsin, LLC

  dba MyEyeDr.

  • Optometrist
  • Kenosha, WI
  • NPI 1164992996
  Medicare reassignment NPD
• Shoptikal LLC

  dba Shopko Optical 4002

  • Eyewear Supplier
  • Green Bay, WI
  • NPI 1659937159

  Optometrist

  Medicare reassignment NPD
• Tedder Optometric Corporation, PC

  • Optometrist
  • Lake Forest, CA
  • NPI 1679262158
  Medicare reassignment NPD
• Troy Humphreys OD Faao, Professional Corporation

  dba Legacy Optometry

  • Optometrist
  • Susanville, CA
  • NPI 1326660960
  Medicare reassignment NPD

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1376685966",
    "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": "14465 POTOMAC MILLS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926807",
            "telephone_number": "703-494-6184",
            "fax_number": "703-499-9744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Brea Mall",
            "address_purpose": "LOCATION",
            "city": "Brea",
            "state": "CA",
            "postal_code": "928215737",
            "country_code": "US",
            "telephone_number": "714-529-2203",
            "fax_number": "714-671-1211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TERESA",
        "middle_name": "DIEMTU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 12954TPA",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3640-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "TPOP23",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009190",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Izabella Petrescu
• Gregory Scott Petruzzi, D.C.
• Gina Cuc Pham, DDS
• Nhu-Oanh Thi Pham, PHARMD
• Shawn Ngoc Pham, MSW, LCSW
• Linh Phan, DDS
• Thoaivan Phan, D.D.S
• Pharmacy One LLC (Pharmacy One)
• Abigail Atienza Phillips, CRNP
• Brenda Phoeuk, OT

• Optometrist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.