NPIMap

Individual provider Active NPI

Dominique James Nguyen, M.D.

  • Family Medicine Physician
  • Renton, WA
National Provider Identifier
1003263617
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60872504 Issued in WA
Practice address
3915 Talbot Rd S Ste 200
Renton, WA 98055-5738
Phone
(425) 690-3400
Fax
(425) 690-0600
NPI assigned
May 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60872504 WA Primary

Addresses

Primary practice location

3915 Talbot Rd S Ste 200
Renton, WA 98055-5738

Mailing address

3915 Talbot Rd S Ste 200
Renton, WA 98055-5738
Phone (425) 690-3400

Other practice location 1

916 Koala Dr
Omak, WA 98841-9759
Phone (509) 663-8711

Other identifiers 1

IdentifierTypeStateIssuer
2059456MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190320002460 WA Practitioner - Family Practice 1557653235 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

3915 Talbot Rd S
Suite 100
Renton, WA 98055-5738
Phone (425) 656-5345

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jan 17, 2022 Accepting new patients
Multicare Health System CurrentSince Jan 17, 2022 Accepting new patients
Valley Medical Group-Renton Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Public Hospital District #1 of King County Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

3915 Talbot Rd S
Ste 100
Renton, WA 98055
Phone (425) 656-5345

3915 Talbot Rd S
Ste 200
Renton, WA 98055
Phone (425) 658-5566

3600 Lind Ave SW
Ste 100
Renton, WA 98057

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

3124 S 19th St
Ste C140
Tacoma, WA 98405
Phone (253) 792-6680

Interoperability endpoints

  • Direct secure messaging: dnguyen110254@direct.valleymed.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1003263617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 TALBOT RD S STE 200",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555738",
            "telephone_number": "425-690-3400",
            "fax_number": "425-690-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 TALBOT RD S STE 200",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555738",
            "telephone_number": "425-690-3400",
            "fax_number": "425-690-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 Koala Dr",
            "address_purpose": "LOCATION",
            "city": "Omak",
            "state": "WA",
            "postal_code": "988419759",
            "country_code": "US",
            "telephone_number": "509-663-8711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DOMINIQUE",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60872504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2059456",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.