Individual provider Active NPI

Hoaiminh Nguyen, P.A-C

  • Physician Assistant
  • Modesto, CA
National Provider Identifier
1083654057
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13044 Issued in CA
Practice address
1441 Florida Avenue
Modesto, CA 95350
Phone
(209) 578-1211
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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 PA13044 CA Primary

Addresses

Primary practice location

1441 Florida Avenue
Modesto, CA 95350

Mailing address

2100 Powell Street
Ste 920
Emeryville, CA 94608-1803
Phone (510) 350-2600

Other identifiers 1

IdentifierTypeStateIssuer
CD0698OtherCAGROUP PTAN GREATER MEDICAL MODESTO SURGICAL ASSOCIATE

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
I20080508000771 CA Practitioner - Physician Assistant 9537248026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA13044CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Nov 1, 2004 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1083654057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL STREET",
            "address_2": "STE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081803",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVENUE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-578-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HOAIMINH",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN  GREATER MEDICAL MODESTO SURGICAL ASSOCIATE",
            "identifier": "CD0698",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.