Tan Duy Vu, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

12670T Issued in CA

Practice address

34859 Fredrick Street
Suite 109
Wildomar, CA 92595-7007

Phone

(951) 678-7690

Fax

(951) 837-4816

NPI assigned

May 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Southern College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Tan D. Vu OD, Inc

  • Optometrist
  • Wildomar, CA
  • NPI 1245457852
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1780638726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34859 FREDRICK STREET",
            "address_2": "SUITE 109",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957007",
            "telephone_number": "951-678-7690",
            "fax_number": "951-837-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34859 FREDRICK STREET",
            "address_2": "SUITE 109",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957007",
            "telephone_number": "951-678-7690",
            "fax_number": "951-837-4816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "TAN",
        "middle_name": "DUY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12670T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0126700",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PIN",
            "identifier": "6143837",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Villanueva
• Irene Villareal, LVN
• Emerald Villarreal
• Noah Villegas
• Victoria Vivernos
• Amanda C Vukovich
• Danijah Janae Wair
• Joshua E Walker, DDS
• William Walker
• Samantha Waltermire

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.