Individual provider Active NPI

Jimmy Tuy Nguyen, O.D.

  • Optometrist
  • Broomall, PA
National Provider Identifier
1962420224
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG-001886 Issued in PA
Practice address
2805 W Chester Pike
Broomall, PA 19008-1827
Phone
(610) 356-3933
Fax
(610) 356-3324
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG-001886 PA Primary

Addresses

Primary practice location

2805 W Chester Pike
Broomall, PA 19008-1827

Mailing address

243 Haverford Rd
Wynnewood, PA 19096-3318
Phone (610) 930-3312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100827000076 PA Practitioner - Optometry 6608990684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Chester Optometry, P.C.Group PAC ID 4082738067, 2 clinicians

Practice addresses (Care Compare)

2805 W Chester Pike
Broomall, PA 19008-1827
Phone (610) 356-3933

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG-001886PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
West Chester Optometry, P.C. Optometrist CurrentSince Jun 14, 2010 Accepting new patients
Davidoff & Associates Inc Optometrist PastSince Jun 14, 2010 Accepting new patients
Sidney I & Jerry P Davidoff PTR Optometrist PastSince Jun 14, 2010 Accepting new patients

Locations

2805 W Chester Pike
Broomall, PA 19008
Phone (610) 356-3933

301 W Boot Rd
West Chester, PA 19380
Phone (610) 430-2060

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1962420224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 HAVERFORD RD",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963318",
            "telephone_number": "610-930-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 W CHESTER PIKE",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190081827",
            "telephone_number": "610-356-3933",
            "fax_number": "610-356-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JIMMY",
        "middle_name": "TUY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG-001886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

Verify at the official NPI Registry.