Active NPI
Hiep Le Nguyen, M.D.
- Pediatrics Physician
- Melbourne, FL
National Provider Identifier
1013909431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME0078745
- Practice address
- 1755 W Hibiscus Blvd
Melbourne, FL 32901-2616 - Phone
- (321) 724-5437
- Fax
- (321) 724-5570
- NPI assigned
- Aug 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME0078745 | FL | Primary |
Addresses
Primary practice location
1755 W Hibiscus Blvd
Melbourne, FL 32901-2616
Mailing address
1755 W Hibiscus Blvd
Melbourne, FL 32901-2616
Phone (321) 724-5437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 258967200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0078745 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group Florida, LLC | Past | Accepting new patients |
Interoperability endpoints
- hiep.nguyen.1@8042.direct.athenahealth.com
Organizations & group practices 1
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.
-
- General Practice Physician
- Indialantic, FL
- NPI 1700649043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238371200000",
"number": "1013909431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1755 W HIBISCUS BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329012616",
"telephone_number": "321-724-5437",
"fax_number": "321-724-5570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1755 W HIBISCUS BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329012616",
"telephone_number": "321-724-5437",
"fax_number": "321-724-5570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "HIEP",
"middle_name": "LE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-22",
"last_updated": "2009-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME0078745",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "258967200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.