Active NPI
Hoa Phuong Nguyen, O.D.
- Optometrist
- Lemon Grove, CA
National Provider Identifier
1962439265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT 12630T
- Practice address
- 7155 Broadway
Lemon Grove, CA 91945-1408 - Phone
- (619) 315-0192
- NPI assigned
- Jun 26, 2006
- 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 | OPT 12630T | CA | Primary |
Addresses
Primary practice location
7155 Broadway
Lemon Grove, CA 91945-1408
Mailing address
7155 Broadway
Lemon Grove, CA 91945-1408
Phone (619) 315-0192
Other practice location 1
3408 College Ave
San Diego, CA 92115-7134
Phone (619) 583-5744
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BB516Z | Other | MEDICARE PTAN |
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 |
|---|---|---|---|---|
| I20040930001144 | CA | Practitioner - Optometry | 3870562382 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT 12630T | CA | MD | Optometrist |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711497600000",
"number": "1962439265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7155 BROADWAY",
"city": "LEMON GROVE",
"state": "CA",
"postal_code": "919451408",
"telephone_number": "619-315-0192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7155 BROADWAY",
"city": "LEMON GROVE",
"state": "CA",
"postal_code": "919451408",
"telephone_number": "619-315-0192"
}
],
"practiceLocations": [
{
"address_1": "3408 College Ave",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921157134",
"country_code": "US",
"telephone_number": "619-583-5744",
"fax_number": "619-582-6112",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "HOA PHUONG",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-26",
"last_updated": "2024-03-27",
"certification_date": "2024-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT 12630T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "BB516Z",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lemon Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.