Active NPI
Kimberly Nguyen
- Optometrist
- West Palm Beach, FL
National Provider Identifier
1740717107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5380
- Practice address
- 12472 89TH PL N
West Palm Beach, FL 33412-2385 - Phone
- (561) 252-2669
- NPI assigned
- May 17, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5380 | FL | Primary |
Addresses
Primary practice location
12472 89TH PL N
West Palm Beach, FL 33412-2385
Mailing address
12472 89TH PL N
West Palm Beach, FL 33412-2385
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210914003494 | FL | Practitioner - Optometry | 2264838382 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5380 | FL | MD | Optometrist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494979200000",
"number": "1740717107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12472 89TH PL N",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334122385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12472 89TH PL N",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334122385",
"telephone_number": "561-252-2669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-17",
"last_updated": "2017-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "5380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.