Khai Gia Phan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3501 Issued in FL

Practice address

19501 NW 27TH Ave
Miami Gardens, FL 33056-2521

Phone

(305) 974-2588

NPI assigned

Mar 30, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Florida, LLCGroup PAC ID 0143541037, 141 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Myeyedr Optometry of Florida, LLC

  • Optometrist
  • Tallahassee, FL
  • NPI 1073907028
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Florida, LLC

  • Optometrist
  • Palm Beach Gardens, FL
  • NPI 1528571478
  NPD
• Myeyedr Optometry of Florida, LLC

  • Optometrist
  • Clearwater, FL
  • NPI 1730054594
  NPD
• Erickson Costello Butler Erickson Optometrist PA

  • Optometrist
  • Lantana, FL
  • NPI 1982753133
  NPD (past)
• Myeyedr Optometry of Florida, LLC

  • Optometrist
  • Perry, FL
  • NPI 1437537529
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1417077710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19501 NW 27TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330562521",
            "telephone_number": "305-974-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19501 NW 27TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330562521",
            "telephone_number": "305-974-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "KHAI",
        "middle_name": "GIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014191100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yasiel Perez
• Yonaisy Perez
• Victor Perlacia Real
• Daisy Dayamit Pernia
• Ashley Petit
• Physical Therapy Now Miami Gardens Inc
• Melissa Barbara Pichs
• Keittya Piedra, CM
• Girard Pierre-Jean
• Kerry Pierre-Philippe, LCSW

• Optometrist in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.