Individual provider Active NPI

Thuy Tam Truong, O.D

  • Optometrist
  • Lawrenceville, GA
National Provider Identifier
1467756874
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002732 Issued in GA
Practice address
1689 Duluth Hwy
Lawrenceville, GA 30043-5010
Phone
(770) 559-9670
Fax
(470) 375-3245
NPI assigned
Dec 28, 2010
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002732 GA Primary
Corneal and Contact Management Optometrist 152WC0802X OPT002732 GA
Low Vision Rehabilitation Optometrist 152WL0500X OPT002732 GA
Pediatric Optometrist 152WP0200X OPT002732 GA
Sports Vision Optometrist 152WS0006X OPT002732 GA
Vision Therapy Optometrist 152WV0400X OPT002732 GA
Occupational Vision Optometrist 152WX0102X OPT002732 GA

Addresses

Primary practice location

1689 Duluth Hwy
Lawrenceville, GA 30043-5010

Mailing address

1689 Duluth Hwy
Lawrenceville, GA 30043-5010
Phone (770) 559-9670

Other identifiers 1

IdentifierTypeStateIssuer
003169929AMedicaidGA

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
I20151202002391 GA Practitioner - Optometry 4183801012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1689 Duluth Hwy
Lawrenceville, GA 30043-5010
Phone (770) 559-9670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14034CAMDProfessional Counselor
OPT002732GAMDOccupational Vision Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sugarloaf Vision Center LLC Optometrist CurrentSince Oct 5, 2015 Accepting new patients
Mark Lynn OD & Associates, PC Optometrist CurrentSince Sep 1, 2018 Accepting new patients
Mark Lynn O.D. & Associates, PC CurrentSince Sep 1, 2018 Accepting new patients

Locations

671 Dawsonville Hwy
Gainesville, GA 30501
Phone (770) 297-3583

1689 Duluth Hwy
Lawrenceville, GA 30043
Phone (770) 559-9670

4825 Sugarloaf Pkwy
Ste F
Lawrenceville, GA 30044
Phone (770) 559-9670

2929 Turner Hill Rd
Ste 2625
Lithonia, GA 30038
Phone (770) 482-5050

Organizations & group practices 3

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": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1467756874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1689 DULUTH HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435010",
            "telephone_number": "770-559-9670",
            "fax_number": "470-375-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1689 DULUTH HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435010",
            "telephone_number": "770-559-9670",
            "fax_number": "470-375-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "THUY TAM",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002732",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "GA",
            "license": "OPT002732",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "GA",
            "license": "OPT002732",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "GA",
            "license": "OPT002732",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "GA",
            "license": "OPT002732",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "GA",
            "license": "OPT002732",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "GA",
            "license": "OPT002732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003169929A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.