DR. MINH CONG TA (O.D.) – Optometrist, NPI 1396712816

DR. MINH CONG TA (O.D.) is a healthcare provider. based in Tucker, Georgia. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. OPT002034 (GA). The NPI Number for DR. MINH CONG TA (O.D.) is 1396712816

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. MINH CONG TA (O.D.)
NPI
1396712816
Phone
(770) 939-7576
Address
4375 Lawrenceville Hwy
Enumeration Date
2 March 2006
Last Update Date
24 December 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7709397576
Graduation Year
2002 (24 years ago)
PAC ID
6608777248
Professional Enrollment ID
I20040116000663
Address ID
GA300843702TU4375XVISO400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

958 OPTOMETRY in GA

Provider Addresses for DR. MINH CONG TA (O.D.)

  • 4375 Lawrenceville Hwy

    Tucker, GA 300843702

    Phone: (770) 939-7576

    Type: Location

  • 1088, Grassmeade Court, HavenStone, Snellville, Gwinnett County, Georgia, 30078, United States

    SNELLVILLE, GA 300785501

    Phone: (770) 331-3926

    Fax: (678) 807-1158

    Type: Mailing

  • 2570 BLACKMON DR STE 350

    DECATUR, GA 300336197

    Phone: (678) 846-2000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $795.

Total Amount is formed as General ($795) + Research ($0) + Ownership ($0) = $795.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: CooperVision Inc. ($214).

Total Amount

$795

General + Research + Ownership

Payments

13

Total payment records

General Amount

$795

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

Top Companies

Largest payers in this snapshot

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-01-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040116000663IOptometryGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30084)

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Reviews

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Frequently asked questions

What number should I use to identify DR. MINH CONG TA (O.D.) for billing?
Administrative and clinical systems typically use NPI 1396712816 for DR. MINH CONG TA (O.D.).
Is DR. MINH CONG TA (O.D.)'s NPI status active today?
Active status means DR. MINH CONG TA (O.D.)'s NPI record is not deactivated in the public file.
What services align with DR. MINH CONG TA (O.D.)'s listing?
DR. MINH CONG TA (O.D.)'s public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
What city is tied to DR. MINH CONG TA (O.D.)?
The directory associates DR. MINH CONG TA (O.D.) with Tucker, Georgia. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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