Individual provider Active NPI

Kim Anh Nguyen, O.D.

  • Optometrist
  • Denton, TX
National Provider Identifier
1629417688
Registry record updated Jun 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8214-T Issued in TX
Practice address
2524 Lillian Miller Pkwy
Suite 100
Denton, TX 76210-7206
Phone
(940) 891-0484
Fax
(940) 383-4700
NPI assigned
Jun 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8214-T TX Primary

Addresses

Primary practice location

2524 Lillian Miller Pkwy
Suite 100
Denton, TX 76210-7206

Mailing address

2524 Lillian Miller Pkwy
Suite 100
Denton, TX 76210-7206
Phone (940) 891-0484

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
I20131202000161 TX Practitioner - Optometry 4688800303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Catherine Spoo Castleberry OD PAGroup PAC ID 5294770590, 4 clinicians

Practice addresses (Care Compare)

2524 Lillian Miller Pkwy
Suite 100
Denton, TX 76210-7206
Phone 94089104842

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8214TXMDAssistant Behavior Analyst
8214-TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Catherine Spoo Castleberry O.D., P.a. Optometrist CurrentSince Nov 15, 2013 Accepting new patients

Locations

2524 Lillian Miller Pkwy
Ste 100
Denton, TX 76210
Phone (940) 891-0484

Interoperability endpoints

  • Direct secure messaging: kim.nguyen@uprisedirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371859200000",
    "number": "1629417688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 LILLIAN MILLER PKWY",
            "address_2": "SUITE 100",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762107206",
            "telephone_number": "940-891-0484",
            "fax_number": "940-383-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 LILLIAN MILLER PKWY",
            "address_2": "SUITE 100",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762107206",
            "telephone_number": "940-891-0484",
            "fax_number": "940-383-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM",
        "middle_name": "ANH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-22",
        "last_updated": "2013-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8214-T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.