Anh Tram Nguyen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002149 Issued in VA

Practice address

13047 Fair Lakes Shopping Ctr
Fairfax, VA 22033-5179

Phone

(703) 449-6739

Fax

(703) 818-0853

NPI assigned

Oct 31, 2012

Last updated

Jul 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Anh Nguyen, O.D. PLLC

  dba Fair Lakes Optometry

  • Optometrist
  • Fairfax, VA
  • NPI 1477285963

  DC

  Medicare reassignment NPD Authorized official
• Tewodros Gedamu, O.D. & Associates, LLC

  dba Dr. Tewodros Gedamu & Associates

  • Optometrist
  • Fairfax, VA
  • NPI 1114101425

  DC

  Medicare reassignment NPD
• Fair Lakes Optometry

  • Optometrist
  • Fairfax, VA
  • NPI 1467974634
  NPD Authorized official
• Steer Optical LLC

  • Medical Specialty Clinic/Center
  • Arlington, VA
  • NPI 1023353638
  NPD (past)

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625270400000",
    "number": "1477807279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12587 FAIR LAKES CIR # 502",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333822",
            "telephone_number": "703-449-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13047 FAIR LAKES SHOPPING CTR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220335179",
            "telephone_number": "703-449-6739",
            "fax_number": "703-818-0853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 S Hayes St",
            "address_2": "Ste 3042",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222024907",
            "country_code": "US",
            "telephone_number": "703-416-1546",
            "fax_number": "703-416-9591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANH",
        "middle_name": "TRAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2021-07-03",
        "certification_date": "2021-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy-Lucy N Ngassa, DNP
• Duc Minh Ngo, M.D.
• Howard T Ngo, DDS
• Amanda N Nguyen, PT, DPT
• Amy Nguyen, DC
• Bao Ngoc Nguyen, D.O.
• Ben L Nguyen, MD
• Bichlan Thi Nguyen, D.D.S.
• Binh Thanh Nguyen
• Calvin Nguyen, EMT

• Optometrist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.