Tracey H Nguyen OD - Professional Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TRACEY H NGUYEN OD - PROFESSIONAL OPTOMETRIC CORPORATION

Practice address

1401 Washington St
Kingsburg, CA 93631-1946

Phone

(559) 897-1071

NPI assigned

May 5, 2018

Last updated

Jan 9, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracey H Nguyen, ODNPI 1467882480

Title

Owner/Ceo

Phone

(602) 349-2933

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tracey Hongthuy Nguyen, OD

  • Optometrist
  • Kingsburg, CA
  • NPI 1467882480
  Medicare reassignment Authorized official
• Thomas Penman, D.P.M.

  • Podiatrist
  • Fresno, CA
  • NPI 1447271382
  NPD (past)
• Shahrzad Shahriary, O.D.

  • Optometrist
  • Tulare, CA
  • NPI 1841332434
  NPD (past)

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

{
    "created_epoch": "1525478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1699264655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 WASHINGTON STREET",
            "city": "KINGSBURG",
            "state": "CA",
            "postal_code": "936313813",
            "telephone_number": "559-897-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 WASHINGTON ST",
            "city": "KINGSBURG",
            "state": "CA",
            "postal_code": "936311946",
            "telephone_number": "559-897-1071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 N Irwin St",
            "address_purpose": "LOCATION",
            "city": "Hanford",
            "state": "CA",
            "postal_code": "932303813",
            "country_code": "US",
            "telephone_number": "559-584-1630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1259 E Prosperity Ave",
            "address_purpose": "LOCATION",
            "city": "Tulare",
            "state": "CA",
            "postal_code": "932748060",
            "country_code": "US",
            "telephone_number": "556-688-5020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRACEY H NGUYEN OD - PROFESSIONAL OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-05",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "602-349-2933",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0697441",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Kingsburg, CA
• Providers in Kingsburg, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.