Individual provider Active NPI

Hanh Judy Ngoc Nguyen, O.D.

  • Optometrist
  • Manteca, CA
National Provider Identifier
1588911820
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14278 Issued in CA
Practice address
158 N Maple Ave
Manteca, CA 95336
Phone
(209) 823-2107
NPI assigned
Aug 6, 2012
Last updated
Jan 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14278 CA Primary

Addresses

Primary practice location

158 N Maple Ave
Manteca, CA 95336

Mailing address

158 N Maple Ave
Manteca, CA 95336-4503

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
I20130708000576 CA Practitioner - Optometry 8527219385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

158 N Maple Ave
Manteca, CA 95336-4503
Phone (209) 815-9820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14278CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Veyes Optometry Inc Optometrist CurrentSince Jan 11, 2021 Accepting new patients

Locations

158 N Maple Ave
Manteca, CA 95336
Phone (209) 239-3504

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": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1588911820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 N MAPLE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 N MAPLE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "95336",
            "telephone_number": "209-823-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HANH JUDY",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2021-01-08",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.