Individual provider Active NPI

Thu Kim Thi Nguyen, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1457634404
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14320 Issued in CA
Practice address
9516 Miramar Rd
San Diego, CA 92126-4533
Phone
(858) 566-4110
Fax
(858) 527-1085
NPI assigned
Sep 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14320 CA Primary

Addresses

Primary practice location

9516 Miramar Rd
San Diego, CA 92126-4533

Mailing address

9516 Miramar Rd
San Diego, CA 92126-4533
Phone (510) 541-4760

Other practice location 1

9516 Miramar Rd
San Diego, CA 92126-4533
Phone (858) 566-4110

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
I20170613002125 CA Practitioner - Optometry 0547538613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

1400 E Palomar St
Chula Vista, CA 91913-1800
Phone (858) 499-2600

9516 Miramar Rd
San Diego, CA 92126-4533
Phone (858) 566-4110

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc Optometrist CurrentSince Oct 23, 2023 Accepting new patients
Eye Connection Optometry, Inc Optometrist CurrentSince Sep 19, 2019 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Optometrist CurrentSince Oct 23, 2023 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

1400 E Palomar St
Chula Vista, CA 91913
Phone (619) 397-3077

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

9516 Miramar Rd
San Diego, CA 92126
Phone (858) 566-4110

Interoperability endpoints

  • Direct secure messaging: tnguyen114524@sharphealthcare.direct-ci.com

Organizations & group practices 4

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": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1457634404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9516 MIRAMAR RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264533",
            "telephone_number": "510-541-4760",
            "fax_number": "858-271-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9516 MIRAMAR RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264533",
            "telephone_number": "858-566-4110",
            "fax_number": "858-527-1085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9516 Miramar Rd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921264533",
            "country_code": "US",
            "telephone_number": "858-566-4110",
            "fax_number": "858-527-1085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THU",
        "middle_name": "KIM THI",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.