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

Last updated

Dec 8, 2015By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• My Eye Dr. Optometrists, LLC

  dba MyEyeDr.

  • 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 (Dimensions Healthcare 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.