Kha Phan Duong, is a medicare enrolled "Optometrist" provider in Dewitt, New York. His current practice location is
3409 Erie Blvd E Unit 200, Dewitt, New York. You can reach out to his office (for appointments etc.) via phone at
(315) 446-4444.
Kha Phan Duong is licensed to practice in New York (license number 009864) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1073293403.
Healthcare Provider's Profile
| Full Name | Kha Phan Duong |
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| Gender | Male |
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| Speciality | Optometrist |
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| Location | 3409 Erie Blvd E Unit 200, Dewitt, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1073293403
- Provider Enumeration Date: 07/20/2023
- Last Update Date: 07/20/2023
Medicare PECOS Information:
- PECOS PAC ID: 7214379528
- Enrollment ID: I20240531000546
Medical Identifiers
Medical identifiers for Kha Phan Duong such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1073293403 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 009864 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kha Phan Duong allows following entities to bill medicare on his behalf.
| Provider Name | Eye Doctors Optical Outlets Pa |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1114012689
PECOS PAC ID: 0042123846
Enrollment ID: O20031107000478 |
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| Provider Name | Michael K Grofik Od Pa |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1295040202
PECOS PAC ID: 5294859047
Enrollment ID: O20100831000265 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kha Phan Duong is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kha Phan Duong,
217-2 Cherry St,
Syracuse, NY 13210
Ph: (321) 806-6466 | Kha Phan Duong,
3409 Erie Blvd E Unit 200,
Dewitt, NY 13214
Ph: (315) 446-4444 |
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