DR. PETER TIEN DZUNG PHAM (O.D.) – Optometrist, NPI 1003155946

DR. PETER TIEN DZUNG PHAM (O.D.) is a healthcare provider. based in Bristow, Virginia. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 0618002204 (VA). The NPI Number for DR. PETER TIEN DZUNG PHAM (O.D.) is 1003155946

Main info

Male
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
DR. PETER TIEN DZUNG PHAM (O.D.)
NPI
1003155946
Phone
(850) 384-1554
Address
11936 JADE LAKE LN
Enumeration Date
13 February 2013
Last Update Date
30 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5712486246
Graduation Year
2012 (14 years ago)
PAC ID
5799908018
Professional Enrollment ID
I20140514000300
Address ID
VA201554072GA14044STXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness85
Years active:13State licenses:1Digital endpointsOther names

1,052 OPTOMETRY in VA

Provider Addresses for DR. PETER TIEN DZUNG PHAM (O.D.)

  • 11936 JADE LAKE LN

    BRISTOW, VA 201362231

    Phone: (850) 384-1554

    Type: Mailing

  • 8300 SUDLEY RD

    STE I-6

    MANASSAS, VA 201093458

    Phone: (850) 384-1554

    Type: Location

  • 11024 OAKTON VIEW DR

    OAKTON, VA 221242439

    Phone: (850) 384-1554

    Type: Mailing

  • 14044 PROMENADE COMMONS ST

    GAINESVILLE, VA 201554072

    Phone: (850) 384-1554

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $664.

Total Amount is formed as General ($664) + Research ($0) + Ownership ($0) = $664.

Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Alcon Vision LLC ($180).

Total Amount

$664

General + Research + Ownership

Payments

16

Total payment records

General Amount

$664

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2014-05-14

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
I20140514000300IOptometryVATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92250Photography of the retina342306$0
92014Established patient complete exam of visual system159159$0
92004New patient complete exam of visual system138138$0
92082Exam of visual field with intermediate testing127126$0
99212Established patient office or other outpatient visit, 10-19 minutes5544$0
View full utilization report →

Insurance plans in this area (ZIP 20136)

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Provider's Procedures

DR. PETER TIEN DZUNG PHAM (O.D.) performs procedures in OPTOMETRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYVA92083Measurement of field of vision during daylight conditions7052

Reviews

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Frequently asked questions

Where can patients find DR. PETER TIEN DZUNG PHAM (O.D.)'s NPI?
You can confirm DR. PETER TIEN DZUNG PHAM (O.D.) with NPI 1003155946; it appears in the national provider directory.
Is DR. PETER TIEN DZUNG PHAM (O.D.) currently active in the NPI registry?
CMS-published data lists DR. PETER TIEN DZUNG PHAM (O.D.) as an active registrant.
Does DR. PETER TIEN DZUNG PHAM (O.D.) list a primary specialty?
If you are matching referrals, note Optometrist for DR. PETER TIEN DZUNG PHAM (O.D.). Clinical services aligned with this taxonomy classification.
Where does public data place DR. PETER TIEN DZUNG PHAM (O.D.)?
The snapshot lists Bristow, Virginia for DR. PETER TIEN DZUNG PHAM (O.D.); download NPPES for the complete set.
Is DR. PETER TIEN DZUNG PHAM (O.D.) a real provider?
This page reflects official NPPES data for NPI 1003155946. Always confirm identity and privileges with the practice and licensing boards.

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