Individual provider Active NPI

Patrick Nguyen

  • Physician Assistant
  • Fountain Valley, CA
National Provider Identifier
1063109197
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA62607 Issued in CA
Practice address
18225 Brookhurst St Ste 6
Fountain Valley, CA 92708-6719
Phone
(714) 200-1499
NPI assigned
Apr 19, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA62607 CA Primary

Addresses

Primary practice location

18225 Brookhurst St Ste 6
Fountain Valley, CA 92708-6719

Mailing address

15901 Plumwood St
Westminster, CA 92683-7283
Phone (714) 725-4432

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
I20230619000056 CA Practitioner - Physician Assistant 7618335985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York at Stony Brook, School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Quy V. Le, MD Inc.Group PAC ID 2264771393, 2 clinicians

Practice addresses (Care Compare)

18225 Brookhurst St
Suite 6
Fountain Valley, CA 92708-6719
Phone (714) 200-1499

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA62607CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Quy V. Le, MD Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pnguyen792130@direct.memorialcare.org

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 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": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1063109197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15901 PLUMWOOD ST",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926837283",
            "telephone_number": "714-725-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18225 BROOKHURST ST STE 6",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086719",
            "telephone_number": "714-200-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PATRICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.