Individual provider Active NPI

Janna Nguyen Pham

  • Optometrist
  • Houston, TX
National Provider Identifier
1619653078
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10853 Issued in TX
Practice address
1977 Butler Blvd FL 2
Houston, TX 77030-4101
Phone
(713) 798-6100
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 10853 TX Primary

Addresses

Primary practice location

1977 Butler Blvd FL 2
Houston, TX 77030-4101

Mailing address

1977 Butler Blvd FL 2
Houston, TX 77030-4101
Phone (713) 798-6100

Other practice location 1

4401 Martin Luther King Blvd
Houston, TX 77204-3069
Phone (713) 743-1921

Other identifiers 1

IdentifierTypeStateIssuer
10853OtherTXOPTOMETRY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230706001468 TX Practitioner - Optometry 7012376296 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

7200 Cambridge St
FL 10
Houston, TX 77030-4202
Phone (713) 798-1000

Merit-based Incentive Payment System (MIPS)

Final score
94.67 of 100Reported as apm
Quality
87.65
Promoting interoperability
92
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10853TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University of Houston System Optometrist CurrentSince Jun 22, 2023 Accepting new patients
University of Houston CurrentSince Jun 22, 2023 Accepting new patients
Baylor College of Medicine Multi-Specialty CurrentSince Sep 1, 2024 Accepting new patients
Baylor College of Medicine Multi-Specialty CurrentSince Sep 1, 2024 Accepting new patients

Locations

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

1977 Butler Blvd
Fl 2
Houston, TX 77030
Phone (713) 798-7321

1977 Butler Blvd
Ste E3
Houston, TX 77030

1 Baylor Plz
#2
Houston, TX 77030

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

1977 Butler Blvd
Houston, TX 77030
Phone (713) 798-4857

4401 Martin Luther King Blvd
Houston, TX 77204
Phone (713) 743-1921

190 Heights Blvd
Houston, TX 77007
Phone (713) 527-8480

Organizations & group practices 4

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": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1619653078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1977 BUTLER BLVD FL 2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304101",
            "telephone_number": "713-798-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 BUTLER BLVD FL 2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304101",
            "telephone_number": "713-798-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Martin Luther King Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "772043069",
            "country_code": "US",
            "telephone_number": "713-743-1921",
            "fax_number": "713-743-0963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JANNA",
        "middle_name": "NGUYEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE",
            "identifier": "10853",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.