Individual provider Active NPI

Melanie Hang Nguyen, O.D.

  • Optometrist
  • Garden Grove, CA
National Provider Identifier
1629419965
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14568 Issued in CA
Practice address
12311 Louise St
Garden Grove, CA 92841-3285
Phone
(714) 867-4517
NPI assigned
Jul 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 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 14568 CA Primary

Addresses

Primary practice location

12311 Louise St
Garden Grove, CA 92841-3285

Mailing address

12311 Louise St
Garden Grove, CA 92841-3285
Phone (714) 867-4517

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
I20131018000964 CA Practitioner - Optometry 5193959575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fifth Optometric Care of CaliforniaGroup PAC ID 4284096298, 22 clinicians

Practice addresses (Care Compare)

22681 Lake Forest Dr
Suite A2
Lake Forest, CA 92630-1799
Phone (949) 837-2121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14568CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fifth Optometric Care of California Optometrist CurrentSince Nov 4, 2023 Accepting new patients
Fifth Optometric Care of California Optometrist Current Accepting new patients
Fifth Optometric Care of California Optometrist CurrentSince Nov 4, 2023 Accepting new patients

Locations

22681 Lake Forest Dr
Ste A2
Lake Forest, CA 92630
Phone (949) 837-2121

3333 Quality Dr
Rncho Cordova, CA 95670
Phone (704) 712-0564

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": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1629419965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12311 LOUISE ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928413285",
            "telephone_number": "714-867-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 LOUISE ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928413285",
            "telephone_number": "714-867-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MELANIE",
        "middle_name": "HANG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.