Organization Active NPI

Dr. Nguyen Associates LLC

  • Optometrist
  • Wethersfield, CT
National Provider Identifier
1730357831
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2615 Issued in CT
Legal business name
DR. NGUYEN ASSOCIATES LLC
Practice address
1402 Berlin Tpke
Wethersfield, CT 06109-1010
Phone
(860) 956-1396
NPI assigned
Feb 12, 2008
Last updated
Apr 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

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

Authorized official

Name
Dr. Kristy Nguyen, O.D.
Title
Optometrist
Phone
(860) 956-1396

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2615 CT Primary

Addresses

Primary practice location

1402 Berlin Tpke
Wethersfield, CT 06109-1010

Mailing address

1402 Berlin Tpke
Wethersfield, CT 06109-1010

Other identifiers 1

IdentifierTypeStateIssuer
1730357831MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000302 CT Part B Supplier - Clinic/Group Practice 3971400433 Receives reassigned benefits from 2 practitioners
Practice locations: Wethersfield, CT

National Provider Directory

National Provider Directory

Locations

1402 Berlin Tpke
Wethersfield, CT 06109
Phone (860) 956-1396

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366934400000",
    "number": "1730357831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 BERLIN TPKE",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 BERLIN TPKE",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091010",
            "telephone_number": "860-956-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. NGUYEN ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2013-04-26",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "860-956-1396",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730357831",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; 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.