Active NPI
Tristan Nguyen-Luu, M.D
- Student in an Organized Health Care Education/Training Program
- Wilkes-Barre, PA
National Provider Identifier
1093458176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1000 E Mountain Blvd
Wilkes-Barre, PA 18711 - Phone
- (570) 808-3745
- NPI assigned
- Apr 18, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1000 E Mountain Blvd
Wilkes-Barre, PA 18711
Mailing address
6897 Campbell Settler Court
Mississauga, ON L5W 1B3
CA
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220816002326 | PA | Order and Referring Only - Internal Medicine | 0648653139 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1093458176",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "6897 CAMPBELL SETTLER COURT",
"city": "MISSISSAUGA",
"state": "ON",
"postal_code": "L5W 1B3"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E MOUNTAIN BLVD",
"city": "WILKES-BARRE",
"state": "PA",
"postal_code": "18711",
"telephone_number": "570-808-3745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN-LUU",
"first_name": "TRISTAN",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-18",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes-Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.