Individual provider Active NPI

Wendy Nguyen

  • Optometrist
  • Salt Lake City, UT
National Provider Identifier
1679953400
Registry record updated Jun 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9421669-9934 Issued in UT
Practice address
500 Foothill Drive Salt Lake City
Salt Lake City, UT 84148-0001
Phone
(801) 582-1565
NPI assigned
Jun 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9421669-9934 UT Primary

Addresses

Primary practice location

500 Foothill Drive Salt Lake City
Salt Lake City, UT 84148-0001

Mailing address

500 Foothill Drive Salt Lake City
Salt Lake City, UT 84148-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20170104002208 NV Practitioner - Optometry 0446531479 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John Chan OD PLLCGroup PAC ID 1052736345, 4 clinicians

Practice addresses (Care Compare)

695 S Green Valley Pkwy
Henderson, NV 89052-0404
Phone (702) 941-7898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
882NVMDOral and Maxillofacial Surgery (Dentist)
9421669-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
John Chan O.D. PLLC Optometrist CurrentSince Oct 4, 2024 Accepting new patients
Miller and Miller, OD LTD Optometrist CurrentSince Nov 2, 2016 Accepting new patients

Locations

695 S Green Valley Pkwy
Henderson, NV 89052
Phone (702) 216-7101

8750 W Charleston Blvd
Las Vegas, NV 89117
Phone (702) 287-4642

6230 N Durango Dr
Las Vegas, NV 89149
Phone (702) 737-3937

Organizations & group practices 2

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": "1433635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433635200000",
    "number": "1679953400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL DRIVE SALT LAKE CITY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL DRIVE SALT LAKE CITY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-582-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "WENDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-07",
        "last_updated": "2015-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "9421669-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.