Individual provider Active NPI

Khanh Hoang, OD

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1396421848
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003504 Issued in GA
Practice address
5505 Peachtree Dunwoody Rd Ste 300
Atlanta, GA 30342-1713
Phone
(404) 257-0814
NPI assigned
Jun 27, 2023
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003504 GA Primary

Addresses

Primary practice location

5505 Peachtree Dunwoody Rd Ste 300
Atlanta, GA 30342-1713

Mailing address

3480 Lakeside Dr NE Apt 1206
Atlanta, GA 30326-1934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240807003049 GA Practitioner - Optometry 4284171299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Eye Surgery Center PC.Group PAC ID 0345148979, 7 clinicians

Practice addresses (Care Compare)

5505 Peachtree Dunwoody Rd
Suite 300
Atlanta, GA 30342-1713
Phone (404) 257-0814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Eye Surgery Center, PC CurrentSince Jul 19, 2024 Accepting new patients

Locations

1903 Phoenix Blvd
Ste 100
Atlanta, GA 30349
Phone (770) 996-6664

3200 Downwood Cir NW
Ste 240
Atlanta, GA 30327
Phone (404) 351-1990

5505 Ptree Dunwoody Rd NE
Ste 300
Sandy Springs, GA 30342
Phone (404) 355-8721

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: khanh.hoang.p41@direct.omnieyeatlanta.nextgenshare.com

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, 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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1396421848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 LAKESIDE DR NE APT 1206",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY RD STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421713",
            "telephone_number": "404-257-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "KHANH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.