Individual provider Active NPI

Nghi Nina Nguyen Phuong Doyle, O.D.

  • Optometrist
  • Crofton, MD
National Provider Identifier
1578524088
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1908 Issued in MD
Practice address
1702 Transportation Blvd
Suite I
Crofton, MD 21114-2149
Phone
(410) 721-2500
Fax
(410) 721-1308
NPI assigned
Apr 1, 2006
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG00148 PA
Optometrist 152W00000X 12306T CA
Optometrist 152W00000X TA1908 MD Primary

Addresses

Primary practice location

1702 Transportation Blvd
Suite I
Crofton, MD 21114-2149

Mailing address

1702 Transportation Blvd
Suite I
Crofton, MD 21114-2149
Phone (410) 721-2500

Other identifiers 1

IdentifierTypeStateIssuer
406792400MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20050210000940 MD Practitioner - Optometry 0244282903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crofton Family Eye Care LLCGroup PAC ID 9335332824, 3 clinicians

Practice addresses (Care Compare)

1702 Transportation Blvd
Suite I
Crofton, MD 21114-2149
Phone (410) 721-2500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12306TCAMDOptometrist
TA1908MDMDOptometrist
OEG00148PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Crofton Family Eye Care LLC Optometrist CurrentSince Sep 14, 2010 Accepting new patients

Locations

1702 Transportation Blvd
Ste I
Crofton, MD 21114
Phone (410) 721-2500

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, 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": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1578524088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 TRANSPORTATION BLVD",
            "address_2": "SUITE I",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142149",
            "telephone_number": "410-721-2500",
            "fax_number": "410-721-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 TRANSPORTATION BLVD",
            "address_2": "SUITE I",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142149",
            "telephone_number": "410-721-2500",
            "fax_number": "410-721-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "NGHI NINA",
        "middle_name": "NGUYEN PHUONG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-01",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG00148",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12306T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406792400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

Verify at the official NPI Registry.