Thuy-Loan Phan

Primary specialty

OptometristTaxonomy code 152W00000X

License

DA2502 Issued in MD

Practice address

14700 Baltimore Ave
Suite 109
Laurel, MD 20707-4877

Phone

(301) 245-3903

NPI assigned

Dec 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South County Community Health Center IncGroup PAC ID 3577474634, shared by 4 NPIs, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• My Eye Dr. Optometrists, LLC

  • Optometrist
  • Burke, VA
  • NPI 1356406581
  NPD (past)

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1871968453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "SUITE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 BALTIMORE AVE",
            "address_2": "SUITE 109",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074877",
            "telephone_number": "301-245-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "THUY-LOAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-08",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "DA2502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katumu Frances Pettiquoi, M.ED
• Lauren Annick Pettyjohn-Robin
• Ryan Peyton
• Pearl Elizabeth Pfuhl, PH.D.
• PGHC Anesthesia Associates
• Louis Markess Pharel, LMSW
• Judith Ann Phibbs, PHD
• Paige Phifer, SLP
• Philanthropy Care LLC
• Joy Ann B Phillips-Schwartz, LCSW-C

• Optometrist in Laurel, MD
• Providers in Laurel, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.