Individual provider Active NPI

Patricia Nguyen Hom, O.D.

  • Optometrist
  • San Jose, CA
National Provider Identifier
1578656153
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11004T Issued in CA
Practice address
1080 S. White Road
Suite a
San Jose, CA 95127-3821
Phone
(408) 272-3002
Fax
(408) 272-0820
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 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 11004T CA Primary
Low Vision Rehabilitation Optometrist 152WL0500X 11004T CA

Addresses

Primary practice location

1080 S. White Road
Suite a
San Jose, CA 95127-3821

Mailing address

1080 S. White Road
Suite a
San Jose, CA 95127-3821
Phone (408) 272-3002

Other identifiers 1

IdentifierTypeStateIssuer
SD0110040MedicaidCA

Other names 1

  • Dr. Patricia Anh-Thu Nguyen Former name

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
I20091001000308 CA Practitioner - Optometry 9830235050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sixth Optometric Care of California PCGroup PAC ID 1153804562, 9 clinicians

Practice addresses (Care Compare)

Rancho Cordova, CA 95670
Phone (916) 851-6323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11004TCAMDOptometrist
11004CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Judy Nguyen, OD, Inc. Optometrist PastSince Apr 15, 2015 Accepting new patients
Judy T. Nguyen, OD Optometrist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1578656153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 S. WHITE ROAD",
            "address_2": "SUITE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273821",
            "telephone_number": "408-272-3002",
            "fax_number": "408-272-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 S. WHITE ROAD",
            "address_2": "SUITE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273821",
            "telephone_number": "408-272-3002",
            "fax_number": "408-272-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOM",
        "first_name": "PATRICIA",
        "middle_name": "NGUYEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11004T",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "11004T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0110040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "NGUYEN",
            "middle_name": "ANH-THU",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.