VIVIEN LE PHAM (OD) – Optometrist, NPI 1366339079

VIVIEN LE PHAM (OD) is a healthcare provider. based in Roeland park, Kansas. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 2025023990 (MO). The NPI Number for VIVIEN LE PHAM (OD) is 1366339079

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
VIVIEN LE PHAM (OD)
NPI
1366339079
Phone
Not provided
Address
5054 CANTERBURY RD
Enumeration Date
24 June 2025
Last Update Date
24 June 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
8164764017
Graduation Year
2025 (1 year ago)
PAC ID
3375046048
Group Practice PAC ID
1153371646
Professional Enrollment ID
I20250910002434
Address ID
MO641558103KA9596XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

863 OPTOMETRY in MO

Provider Addresses for VIVIEN LE PHAM (OD)

  • 5054 CANTERBURY RD

    ROELAND PARK, KS 662051621

    Phone:

    Type: Mailing

  • 9596 N MCGEE ST

    KANSAS CITY, MO 641558103

    Phone: (816) 476-4017

    Type: Location

  • 2100 E Mechanic St

    Harrisonville, MO 647012057

    Phone: (816) 884-5212

    Type: Location

  • 19045 E Valley View Pkwy Ste A

    Independence, MO 640557030

    Phone: (816) 795-7777

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-09-10

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
I20250910002434IOptometryMOTBD

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 66205)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153371646View full group profile
NameSpecialtyState
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMN
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YKS

Reviews

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Frequently asked questions

How is VIVIEN LE PHAM (OD) identified in CMS data?
CMS-hosted NPPES data lists VIVIEN LE PHAM (OD) with NPI 1366339079.
Is VIVIEN LE PHAM (OD) listed as active for patients and plans?
The listing shows VIVIEN LE PHAM (OD) as active in the NPI system.
What taxonomy line describes VIVIEN LE PHAM (OD)?
For research purposes, treat VIVIEN LE PHAM (OD) as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for VIVIEN LE PHAM (OD)?
VIVIEN LE PHAM (OD)'s geographic hint is Roeland Park, Kansas in our summary view.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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