Individual provider Active NPI

Vincent Tien Nguyen, OD

  • Optometrist
  • Palo Alto, CA
National Provider Identifier
1588389787
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
35333 Issued in CA
Practice address
109 California Ave # D101A
Palo Alto, CA 94306-1926
Phone
(650) 322-6656
NPI assigned
Oct 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 35333 CA Primary

Addresses

Primary practice location

109 California Ave # D101A
Palo Alto, CA 94306-1926

Mailing address

2242 Seacliff Dr
Milpitas, CA 95035-6639
Phone (408) 839-6353

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
I20230125001940 CA Practitioner - Optometry 1951772185 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35333CAMDCritical Care Certified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Palo Alto Vision Optometry Inc Optometrist CurrentSince Jan 17, 2023 Accepting new patients
Michael D Le Optometric Corporation Optometrist CurrentSince Jan 17, 2023 Accepting new patients

Locations

109 California Ave
#D101A
Palo Alto, CA 94306
Phone (650) 322-6656

109 California Ave
Ste D101A
Palo Alto, CA 94306
Phone (650) 322-6656

Organizations & group practices 2

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1588389787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2242 SEACLIFF DR",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950356639",
            "telephone_number": "408-839-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CALIFORNIA AVE # D101A",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061926",
            "telephone_number": "650-322-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VINCENT",
        "middle_name": "TIEN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.