Organization Active NPI

Nguyen Ky DPM, Inc

  • Foot & Ankle Surgery Podiatrist
  • San Jose, CA
National Provider Identifier
1073785960
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4689 Issued in CA
Legal business name
NGUYEN KY DPM, INC
Practice address
660 E Santa Clara St
San Jose, CA 95112-1931
Phone
(408) 292-2485
Fax
(408) 292-3330
NPI assigned
Mar 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Authorized official

Name
Dr. Nguyen Ky, DPMNPI 1740392208
Title
President
Phone
(408) 292-2485

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X E4689 CA Primary

Addresses

Primary practice location

660 E Santa Clara St
San Jose, CA 95112-1931

Mailing address

660 E Santa Clara St
San Jose, CA 95112-1931
Phone (408) 292-2485

Other identifiers 1

IdentifierTypeStateIssuer
000E46890MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080618000542 CA Part B Supplier - Clinic/Group Practice 0042381006 Receives reassigned benefits from 1 practitioner
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Locations

2365 Quimby Rd
#250
San Jose, CA 95122
Phone (408) 292-2485

2365 Quimby Rd
Ste 250
San Jose, CA 95122
Phone (650) 502-4770

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1073785960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 E SANTA CLARA ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951121931",
            "telephone_number": "408-292-2485",
            "fax_number": "408-292-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 E SANTA CLARA ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951121931",
            "telephone_number": "408-292-2485",
            "fax_number": "408-292-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGUYEN KY DPM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "KY",
        "authorized_official_first_name": "NGUYEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-292-2485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E46890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.