Sandy Pham-Vang, OD

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

3056 Issued in MN

Practice address

7074 Brooklyn Blvd
Brooklyn Center, MN 55429-1370

Phone

(763) 316-4193

Fax

(763) 363-0002

NPI assigned

Jul 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Pham-Vang Optometry LLC

  • Optometrist
  • Brooklyn Center, MN
  • NPI 1831330679
  Medicare reassignment Authorized official
• Pham-Vang Optometry LLC

  • Health Maintenance Organization
  • Brooklyn Center, MN
  • NPI 1467800664
  NPD Authorized official

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1689607780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7074 BROOKLYN BLVD",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554291370",
            "telephone_number": "763-316-4193",
            "fax_number": "763-363-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7074 BROOKLYN BLVD",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554291370",
            "telephone_number": "763-316-4193",
            "fax_number": "763-363-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM-VANG",
        "first_name": "SANDY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MN",
            "license": "3056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Peterson
• Andrea Sheree Petitt
• Peter George Pfeiffer
• Pham-Vang Optometry LLC
• Pham-Vang Optometry LLC
• Jack Edward Philbin
• Danayah M Phillips
• Mar'Shell Phillips
• PHS Maranatha Inc.
• Jacquline Elizabeth Piccolin

• Corneal and Contact Management Optometrist in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Corneal and Contact Management Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.