Active NPI
Jennie Nguyen, O.D.
- Optometrist
- Sacramento, CA
National Provider Identifier
1912200189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 14042
- Practice address
- 1601 Arden Way
Sacramento, CA 95815-4004 - Phone
- (916) 921-9501
- NPI assigned
- Dec 10, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14042 | CA | Primary |
Addresses
Primary practice location
1601 Arden Way
Sacramento, CA 95815-4004
Mailing address
634 M St
Davis, CA 95616-3910
Phone (510) 457-5339
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120725000412 | CA | Order and Referring Only - Optometry | 4082870704 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Kansas City, MO
- NPI 1497412522
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291939200000",
"number": "1912200189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "634 M ST",
"city": "DAVIS",
"state": "CA",
"postal_code": "956163910",
"telephone_number": "510-457-5339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 ARDEN WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958154004",
"telephone_number": "916-921-9501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "JENNIE",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-10",
"last_updated": "2010-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.