Individual provider Active NPI

Yen Nguyen, OD

  • Optometrist
  • Brookline, MA
National Provider Identifier
1609567528
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5611 Issued in MA
Practice address
24 Webster PL
Brookline, MA 02445-7937
Phone
(617) 202-2020
Fax
(617) 734-3264
NPI assigned
May 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 5611 MA Primary

Addresses

Primary practice location

24 Webster PL
Brookline, MA 02445-7937

Mailing address

24 Webster PL
Brookline, MA 02445-7937
Phone (617) 202-2020

Other practice location 1

204 Worcester St
Wellesley, MA 02481-5473
Phone (617) 202-2020

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
I20230725000275 MA Practitioner - Optometry 7416317300 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Laser Eye Institute PCGroup PAC ID 9739123381, 23 clinicians
Suzanne Lucash OD PLLCGroup PAC ID 8921264052, 5 clinicians

Practice addresses (Care Compare)

204 Worcester St
Wellesley, MA 02481-5473
Phone (617) 202-2020

4 Lyman St
Westboro, MA 01581-1419
Phone (508) 366-7461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5611MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lickteig Family Eyecare PC Optometrist CurrentSince Jul 12, 2023 Accepting new patients
Suzanne Lucash O.D. PLLC Optometrist CurrentSince Apr 28, 2025 Accepting new patients

Locations

870 Providence Hwy
Dedham, MA 02026
Phone (781) 328-0067

15 Brook St
Ste 3
Medfield, MA 02052

4110 Mystic Valley Pkwy
Medford, MA 02155
Phone (781) 350-7008

1245 Worcester St
Ste 1024
Natick, MA 01760
Phone (508) 653-0223

4 Lyman St
Westborough, MA 01581
Phone (508) 366-1766

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": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1609567528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WEBSTER PL",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457937",
            "telephone_number": "617-202-2020",
            "fax_number": "617-734-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 WEBSTER PL",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457937",
            "telephone_number": "617-202-2020",
            "fax_number": "617-734-3264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Worcester St",
            "address_purpose": "LOCATION",
            "city": "Wellesley",
            "state": "MA",
            "postal_code": "024815473",
            "country_code": "US",
            "telephone_number": "617-202-2020",
            "fax_number": "617-734-3264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "YEN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.