Phung Kim Nguyen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5127 Issued in OK

Practice address

12190 S Waco Ave Ste C
Glenpool, OK 74033-5661

Phone

(918) 936-2882

NPI assigned

Dec 26, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
• Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pnguyen283352@direct.saintfrancis.com

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.

• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  Medicare reassignment Care Compare group NPD
• Williams Medical Group Practice, LLC

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1346608809
  Medicare reassignment NPD
• Williams Medical Group Practice, LLC

  • Rural Health Clinic/Center
  • Collinsville, OK
  • NPI 1215751508
  NPD
• Williams Medical Group Practice, LLC

  • Rural Health Clinic/Center
  • Glenpool, OK
  • NPI 1821867557
  NPD (past)
• Williams Medical Group Practice, LLC

  • Rural Health Clinic/Center
  • Great Bend, KS
  • NPI 1821668674
  NPD (past)

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

• Saint Francis Hospital South LLC

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1376561944
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1003039488
  Care Compare affiliation
• Saint Francis Hospital, Inc.

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1144228487
  Care Compare affiliation

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

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1033988522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12190 S WACO AVE STE C",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740335661",
            "telephone_number": "918-936-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12190 S WACO AVE STE C",
            "city": "GLENPOOL",
            "state": "OK",
            "postal_code": "740335661",
            "telephone_number": "918-936-2882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6465 S Yale Ave Ste 704",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741367822",
            "country_code": "US",
            "telephone_number": "918-502-4250",
            "fax_number": "918-502-4255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUNG",
        "middle_name": "KIM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-26",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medication Advisors, PLLC
• Alice Metallaoui, DPH
• Suraya Lynn Mikus
• Beverly Margaret Myers, D.PH.
• Daree Ione New, BSW
• Ryan K Noah, DDS
• Nurse on Demand
• Carissa O'Dell, B.S.
• Okdds PLLC
• Osu Center for Health Sciences

• Physician Assistant in Glenpool, OK
• Providers in Glenpool, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.