Individual provider Active NPI

Richard Thanh Ngo, DC

  • Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1083647820
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
22764 Issued in CA
Practice address
3701 J St Ste 201a
Sacramento, CA 95816-5542
Phone
(916) 454-2345
NPI assigned
Jul 7, 2006
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 22764 CA Primary
Chiropractor 111N00000X DC28407 CA

Addresses

Primary practice location

3701 J St Ste 201a
Sacramento, CA 95816-5542

Mailing address

PO Box 580668
Elk Grove, CA 95758-0012
Phone (916) 454-2345

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
I20170411000361 CA Practitioner - Nurse Practitioner 8325366412 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DC28407CAMDChiropractor
22764CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elica Health Centers CurrentSince Feb 27, 2017 Accepting new patients

Locations

1860 Howe Ave
Ste 440
Sacramento, CA 95825

3701 J St
Ste 201
Sacramento, CA 95816
Phone (916) 454-0184

155 15th St
Ste A
West Sacramento, CA 95691
Phone (916) 375-8981

Interoperability endpoints

  • Direct secure messaging: rngo343153@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1083647820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580668",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957580012",
            "telephone_number": "916-454-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 J ST STE 201A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165542",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "RICHARD",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "22764",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28407",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.