Individual provider Active NPI

Tran Ngoc Nguyen, MD

  • Family Medicine Physician
  • Bethel, CT
National Provider Identifier
1033616925
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
68618 Issued in CT
Practice address
2 Elizabeth St
Bethel, CT 06801-2100
Phone
(203) 791-2221
NPI assigned
Apr 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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 68618 CT Primary

Addresses

Primary practice location

2 Elizabeth St
Bethel, CT 06801-2100

Mailing address

2 Elizabeth St
Bethel, CT 06801-2100
Phone (203) 791-2221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210824001777 CT Practitioner - Family Practice 5890190219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Stony Brook, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

2 Elizabeth St
Bethel, CT 06801-2100
Phone (203) 791-2221

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Village Square Internal Medicine PC PastSince Jul 17, 2021 Accepting new patients

Locations

8 Elizabeth St
Bethel, CT 06801

2 Elizabeth St
Bethel, CT 06801
Phone (203) 791-2221

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: tran.nguyen.npi1033616925.phpct@direct.optumcare.masshiway.net

Organizations & group practices 2

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 6

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1033616925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ELIZABETH ST",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068012100",
            "telephone_number": "203-791-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ELIZABETH ST",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068012100",
            "telephone_number": "203-791-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRAN",
        "middle_name": "NGOC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "68618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, CT

Sources for this page

Verify at the official NPI Registry.