Individual provider Active NPI

Venus Nguyen

  • Family Nurse Practitioner
  • El Centro, CA
National Provider Identifier
1053705087
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95001830 Issued in CA
Practice address
1699 N Imperial Ave
El Centro, CA 92243-1320
Phone
(760) 352-2551
Fax
(888) 631-5155
NPI assigned
Mar 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95001830 CA Primary

Addresses

Primary practice location

1699 N Imperial Ave
El Centro, CA 92243-1320

Mailing address

1699 N Imperial Ave
El Centro, CA 92243-1320
Phone (442) 283-3494

Other practice location 1

290 Main St
Brawley, CA 92227-2351
Phone (760) 352-2551 ext. 3494

Other practice location 2

222 E Cole Blvd
Calexico, CA 92231-3211
Phone (760) 352-2551 ext. 3494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20220712003771 CA Practitioner - Nurse Practitioner 0941577001 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95001830CAMDFamily Nurse Practitioner
95001830CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Manor Skilled Nursing Inc CurrentSince Aug 10, 2024 Accepting new patients
Vo Medical Center CurrentSince May 1, 2022 Accepting new patients
Legacy MD Medical Group Inc CurrentSince Sep 3, 2023 Accepting new patients
Vo Medical Center CurrentSince May 1, 2022 Accepting new patients
Legacy MD Medical Group Inc PastSince May 28, 2024 Accepting new patients

Locations

290 Main St
Brawley, CA 92227
Phone (760) 352-2551

222 E Cole Blvd
Calexico, CA 92231
Phone (760) 352-2551

222 E Cole Blvd
Ste C
Calexico, CA 92231
Phone (760) 352-2551

690 Otay Lakes Rd
Ste 120
Chula Vista, CA 91910
Phone (619) 397-7800

690 Otay Lakes Rd
Ste 125
Chula Vista, CA 91910
Phone (760) 352-2551

1699 N Imperial Ave
El Centro, CA 92243
Phone (442) 283-3494

1590 S Imperial Ave
El Centro, CA 92243
Phone (760) 352-2551

81812 Doctor Carreon Blvd
Ste E
Indio, CA 92201
Phone (442) 236-1498

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJDADD/Endpoint/AJDADD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Imperial Valley Rural Health ClinicBrawley, CA, CCN 558914 Rural health clinic Contracted Managing Employee Aug 30, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1053705087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 N IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922431320",
            "telephone_number": "442-283-3494",
            "fax_number": "888-631-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 N IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922431320",
            "telephone_number": "760-352-2551",
            "fax_number": "888-631-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 Main St",
            "address_purpose": "LOCATION",
            "city": "Brawley",
            "state": "CA",
            "postal_code": "922272351",
            "country_code": "US",
            "telephone_number": "760-352-2551 x3494",
            "fax_number": "888-631-5150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 E Cole Blvd",
            "address_purpose": "LOCATION",
            "city": "Calexico",
            "state": "CA",
            "postal_code": "922313211",
            "country_code": "US",
            "telephone_number": "760-352-2551 x3494",
            "fax_number": "888-631-5150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VENUS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95001830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.