Individual provider Active NPI

Han Le Duong, OD

  • Optometrist
  • San Jose, CA
National Provider Identifier
1437446036
Registry record updated Jul 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14163 Issued in CA
Practice address
713 Blackfoot CT
San Jose, CA 95123-4105
Phone
(408) 204-9095
NPI assigned
Jul 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14163 CA Primary

Addresses

Primary practice location

713 Blackfoot CT
San Jose, CA 95123-4105

Mailing address

630 Blossom Hill Rd Ste 20
San Jose, CA 95123-3056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20161007001312 CA Practitioner - Optometry 1658678511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern California College of Optometry, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

107 Park PL
Falls Church, VA 22046-4513

901 Walnut St
Philadelphia, PA 19107-5214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Han Duong Optometry, Inc Optometrist CurrentSince Aug 3, 2016 Accepting new patients

Locations

630 Blossom Hill Rd
Ste 20
San Jose, CA 95123
Phone (408) 300-0717

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": "1309564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468713600000",
    "number": "1437446036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 BLOSSOM HILL RD STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 BLACKFOOT CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951234105",
            "telephone_number": "408-204-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "HAN",
        "middle_name": "LE",
        "name_prefix": "Miss",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-02",
        "last_updated": "2016-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.