Individual provider Active NPI

Nguyet Thuy Duong, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Elmhurst, NY
National Provider Identifier
1063641074
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
305140 Issued in NY
Practice address
8635 Queens Blvd Ste 1B
Elmhurst, NY 11373-4408
Phone
(718) 286-9176
NPI assigned
Jul 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 305140 NY Primary

Addresses

Primary practice location

8635 Queens Blvd Ste 1B
Elmhurst, NY 11373-4408

Mailing address

3336 71St St
Jackson Heights, NY 11372-1057
Phone (718) 286-9176

Other identifiers 1

IdentifierTypeStateIssuer
03435343MedicaidNY

Other names 1

  • Mrs. Moon Duong Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210407002544 NY Practitioner - Nurse Practitioner 0941569867 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8635 Queens Blvd
Suite 1B
Elmhurst, NY 11373-4408
Phone (929) 312-9887

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
305140NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Moon Adult Health NP PLLC Adult Health CurrentSince Mar 1, 2021 Accepting new patients
Alicia Almendral MD PLLC CurrentSince Apr 1, 2022 Accepting new patients
Cuidado Medico Y Geriatrico of Queens PC CurrentSince May 18, 2024 Accepting new patients

Locations

8635 Queens Blvd
Ste 1B
Elmhurst, NY 11373
Phone (718) 533-8588

3744 75th St
Jackson Hts, NY 11372
Phone (718) 672-5529

4135 67th St
Ste MD1
Woodside, NY 11377
Phone (347) 808-9400

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: nduong675018@nychhc.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IBACBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/BHJECD/Endpoint/BHJECD

Organizations & group practices 3

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": "1247270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1063641074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3336 71ST ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113721057",
            "telephone_number": "718-286-9176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 QUEENS BLVD STE 1B",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734408",
            "telephone_number": "718-286-9176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "NGUYET",
        "middle_name": "THUY",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-11",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "305140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03435343",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOON",
            "last_name": "DUONG",
            "prefix": "MRS.",
            "credential": "NURSE PRACTITIONER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.