Individual provider Active NPI

Tien Nguyen, CRNP

  • Primary Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1083462576
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AG02240018 Issued in PA
Practice address
7515 Stenton Ave
Philadelphia, PA 19150-3710
Phone
(267) 335-5264
Fax
(267) 335-5273
NPI assigned
May 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AG02240018 PA Primary

Addresses

Primary practice location

7515 Stenton Ave
Philadelphia, PA 19150-3710

Mailing address

607 N Wales Rd
North Wales, PA 19454-1724
Phone (267) 884-6738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240715003225 PA Practitioner - Nurse Practitioner 9133664055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Medical CenterGroup PAC ID 7315132537, 20 clinicians

Practice addresses (Care Compare)

7515 Stenton Ave
Philadelphia, PA 19150-3710
Phone (267) 335-5264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AG02240018PAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Medical Center CurrentSince Jun 10, 2024 Accepting new patients

Locations

208 W Chelten Ave
Philadelphia, PA 19144
Phone (215) 849-3104

7515 Stenton Ave
#A
Philadelphia, PA 19150

7515 Stenton Ave
Philadelphia, PA 19150
Phone (215) 842-5246

100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200

Interoperability endpoints

  • Direct secure messaging: tien.nguyen.1@25233.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25233/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1083462576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 N WALES RD",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194541724",
            "telephone_number": "267-884-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7515 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503710",
            "telephone_number": "267-335-5264",
            "fax_number": "267-335-5273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TIEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "AG02240018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.