Individual provider Active NPI

Thien Kim Nguyen Vuong, O.D.

  • Optometrist
  • Fresno, CA
National Provider Identifier
1669745782
Registry record updated Sep 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
15154 Issued in CA
Practice address
7075 N Sharon Ave
Fresno, CA 93720-3329
Phone
(559) 486-2000
Fax
(559) 256-8575
NPI assigned
Feb 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1826 AZ
Optometrist 152W00000X 003273 GA
Optometrist 152W00000X 15154 CA Primary

Addresses

Primary practice location

7075 N Sharon Ave
Fresno, CA 93720-3329

Mailing address

4280 East West Connector SE
Smyrna, GA 30082-4804
Phone (559) 486-2000

Other identifiers 1

IdentifierTypeStateIssuer
1826OtherAZAZ STATE BOARD OF OPTOMETRY

Other names 1

  • Dr. Thien Kim Tran Nguyen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20201001000270 GA Practitioner - Optometry 1254579196 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smyrna Eye Group, P.C.Group PAC ID 2163403510, 4 clinicians
Center for the Visually ImpairedGroup PAC ID 8527009034, 9 clinicians
Daniel Tulman OD PCGroup PAC ID 8426961194, 5 clinicians

Practice addresses (Care Compare)

4280 E W Connector SE
Smyrna, GA 30082
Phone (770) 435-4457

739 W Peachtree St NW
Atlanta, GA 30308-1137
Phone (404) 875-9011

880 Crestmark Dr
Suite 101
Lithia Springs, GA 30122-2646
Phone (770) 948-0036

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1826AZMDGeneral Practice Dentistry
15154CAMDSports Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for the Visually Impaired CurrentSince Oct 7, 2020 Accepting new patients
Tulman Eye Group, PC Optometrist CurrentSince Mar 31, 2025 Accepting new patients

Locations

880 Crestmark Dr
Lithia Springs, GA 30122

880 Crestmark Dr
Ste 101
Lithia Springs, GA 30122
Phone (770) 948-0036

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": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601164800000",
    "number": "1669745782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 EAST WEST CONNECTOR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300824804",
            "telephone_number": "559-486-2000",
            "fax_number": "559-256-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7075 N SHARON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203329",
            "telephone_number": "559-486-2000",
            "fax_number": "559-256-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUONG",
        "first_name": "THIEN KIM",
        "middle_name": "NGUYEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-21",
        "last_updated": "2020-09-27",
        "certification_date": "2020-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1826",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "003273",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ STATE BOARD OF OPTOMETRY",
            "identifier": "1826",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THIEN KIM",
            "last_name": "NGUYEN",
            "middle_name": "TRAN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.