Individual provider Active NPI

Michael H Vuong, O.D.

  • Optometrist
  • St Augustine, FL
National Provider Identifier
1790049336
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4849 Issued in FL
Practice address
7458 US Highway 1 N Ste B-105
St Augustine, FL 32095-8556
Phone
(904) 274-2706
NPI assigned
Jun 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4849 FL Primary

Addresses

Primary practice location

7458 US Highway 1 N Ste B-105
St Augustine, FL 32095-8556

Mailing address

7458 US Highway 1 N Ste B-105
St Augustine, FL 32095-8556

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140618000575 FL Practitioner - Optometry 1850549676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Florida, LLCGroup PAC ID 0143541037, 141 clinicians

Practice addresses (Care Compare)

1480 Timberlane Rd
Tallahassee, FL 32312-1713
Phone (850) 893-4005

7458 US 1
Suite B 105
St Augustine, FL 32095-8556
Phone (904) 274-2706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4849FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients

Locations

3011 W Yamato Rd
Ste A19
Boca Raton, FL 33434
Phone (561) 995-9600

2140 Crawfordville Hwy
Crawfordville, FL 32327
Phone (850) 926-9213

7458 US Highway 1 N
Ste B105
Saint Augustine, FL 32095
Phone (904) 274-2706

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1790049336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7458 US HIGHWAY 1 N STE B-105",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7458 US HIGHWAY 1 N STE B-105",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958556",
            "telephone_number": "904-274-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUONG",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.