Individual provider Active NPI

My Lien Nguyen, O.D.

  • Optometrist
  • Brookhaven, GA
National Provider Identifier
1902254105
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003149 Issued in GA
Practice address
1418 Dresden Dr NE
Brookhaven, GA 30319-3598
Phone
(404) 239-0272
Fax
(404) 239-0298
NPI assigned
May 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6487 OH
Optometrist 152W00000X OPT003149 GA Primary

Addresses

Primary practice location

1418 Dresden Dr NE
Brookhaven, GA 30319-3598

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160811000571 OH Practitioner - Optometry 3779877980 Reassigns benefits to 1 organization
I20220602003177 GA Practitioner - Optometry 3779877980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians

Practice addresses (Care Compare)

1418 Dresden Dr NE
Brookhaven, GA 30319-3598
Phone (404) 239-0272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Aug 8, 2019 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jun 12, 2022 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jun 12, 2022 Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Ohio, LLC Optometrist CurrentSince Aug 8, 2019 Accepting new patients

Locations

6121 Cedarcrest Rd NW
#108
Acworth, GA 30101
Phone (770) 529-7789

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

1415 Wooten Lake Rd NW
Ste 100
Kennesaw, GA 30144
Phone (770) 424-2020

8340 Colerain Ave
Cincinnati, OH 45239
Phone (513) 245-9099

5303 Glenway Ave
Cincinnati, OH 45238
Phone (513) 921-8040

8254 Mayberry Sq N
Sylvania, OH 43560
Phone (419) 885-5300

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 6

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": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1902254105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 DRESDEN DR NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193598",
            "telephone_number": "404-239-0272",
            "fax_number": "404-239-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MY LIEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6487",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.