Individual provider Active NPI

Justin Van Minh Nguyen, MD

  • Urology Physician
  • Raleigh, NC
National Provider Identifier
1093205478
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2023-01224 Issued in NC
Practice address
10010 Falls of Neuse Rd
Raleigh, NC 27614-8494
Phone
(919) 350-1570
NPI assigned
May 11, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2023-01224 NC Primary

Addresses

Primary practice location

10010 Falls of Neuse Rd
Raleigh, NC 27614-8494

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-2266

Other practice location 1

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230809000679 NC Practitioner - Urology 0244586790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Texas Medical School at Houston, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

10010 Falls of Neuse Rd
Raleigh, NC 27614-8494
Phone (919) 766-8989

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2023-01224NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC Urology Current Accepting new patients
Wakemed Specialists Group LLC Urology CurrentSince Aug 28, 2023 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Aug 28, 2023 Accepting new patients

Locations

210 Ashville Ave
Cary, NC 27518
Phone (919) 235-6460

400 US 70 Hwy E
Garner, NC 27529
Phone (919) 235-6400

101 Holly Creek Rd
Morrisville, NC 27560
Phone (919) 235-6480

10010 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1380

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

23 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 322-4800

1030 Siena Dr
Wake Forest, NC 27587
Phone (919) 235-6511

Interoperability endpoints

  • Direct secure messaging: jnguyen471331@directhisp.wakemed.org

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1093205478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "919-350-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 FALLS OF NEUSE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148494",
            "telephone_number": "919-350-1570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JUSTIN",
        "middle_name": "VAN MINH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-11",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2023-01224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.