Phuong Ngoc Nguyen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 13294 Issued in CA

Practice address

1855 41St Ave Ste G11
Capitola, CA 95010-2509

Phone

(831) 475-6519

Fax

(831) 475-0754

NPI assigned

Jul 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avani Patel Optometric CorporationGroup PAC ID 1052780632, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Avani Patel Optometric Corporation

  • Optometrist
  • Fresno, CA
  • NPI 1659096220
  Medicare reassignment Care Compare group NPD
• William L. Wilson, M.D., Inc.

  • Interventional Pain Medicine Physician
  • La Mesa, CA
  • NPI 1568424687
  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1710177977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 NORTHRIDGE MALL # F8",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939062014",
            "telephone_number": "831-443-5250",
            "fax_number": "831-443-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 41ST AVE STE G11",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102509",
            "telephone_number": "831-475-6519",
            "fax_number": "831-475-0754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "670 Northridge Mall # F8",
            "address_purpose": "LOCATION",
            "city": "Salinas",
            "state": "CA",
            "postal_code": "939062014",
            "country_code": "US",
            "telephone_number": "831-443-5250",
            "fax_number": "831-443-6921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUONG",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 13294",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynne Neubauer, LCSW
• Kathy H NG, OD
• Bao Gia Nguyen, RPH
• Kim Thien Nguyen, MD
• Michael Nguyen, DO
• Sossity Nico, LMFT
• Patricia S. Noel, PH.D.
• Kelly Norman
• Charlene Norquist, MPT
• Jason Lyle Novick, D.P.M.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.