Individual provider Active NPI

Thao M Dung, OPTOMETRIST

  • Optometrist
  • Wellesley, MA
National Provider Identifier
1558438101
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT5329 Issued in MA
Practice address
1 Washington St Ste 101
Wellesley, MA 02481-1706
Phone
(781) 263-7360
Fax
(510) 799-7734
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11418T CA
Optometrist 152W00000X OPT5329 MA Primary

Addresses

Primary practice location

1 Washington St Ste 101
Wellesley, MA 02481-1706

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • Dr. Thao Dung Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20190829002404 MA Practitioner - Optometry 9335179522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass Optometric Associates, PLLCGroup PAC ID 0648362442, 50 clinicians

Practice addresses (Care Compare)

100 State St
Boston, MA 02109-2403
Phone (617) 742-2076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11418CAMDMental Health Counselor
5329MAMDMental Health Counselor
11418TCAMDOptometrist
OPT5329MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mass Optometric Associates, PLLC Optometrist CurrentSince Jul 13, 2019 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Oct 16, 2023 Accepting new patients
Mass Optometric Associates, PLLC Optometrist CurrentSince Jul 13, 2019 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist Current Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Oct 16, 2023 Accepting new patients
Milner & Lau Optometric Corporation Optometrist Past Accepting new patients

Locations

22 University Dr
Amherst, MA 01002
Phone (413) 549-9400

700 Boston Rd
Billerica, MA 01821
Phone (978) 667-0481

100 State St
Boston, MA 02109
Phone (617) 742-2076

1 Washington St
Ste 101
Wellesley Hills, MA 02481
Phone (617) 332-1471

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 6

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1558438101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON ST STE 101",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024811706",
            "telephone_number": "781-263-7360",
            "fax_number": "510-799-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNG",
        "first_name": "THAO",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11418T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "OPT5329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THAO",
            "last_name": "DUNG",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.