Individual provider Active NPI

Binh T Nguyen, D.O

  • Cardiovascular Disease Physician
  • Pontiac, MI
National Provider Identifier
1093933665
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036135508 Issued in IL
Practice address
50 N Perry St
Pontiac, MI 48342-2217
Phone
(248) 338-5392
NPI assigned
Apr 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101016741 MI
Clinical Cardiac Electrophysiology Physician 207RC0001X 57239-21 WI
Clinical Cardiac Electrophysiology Physician 207RC0001X 5101016741 MI
Cardiovascular Disease Physician 207RC0000X 036135508 IL Primary

Addresses

Primary practice location

50 N Perry St
Pontiac, MI 48342-2217

Mailing address

PO Box 955860
Saint Louis, MO 63195-2217
Phone (636) 498-5944

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bnguyen115920@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20140805001009 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 3476628421 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Regional Health CenterGroup PAC ID 1658272059, 155 clinicians
Physician Services Corporation of Southern Illinois IncGroup PAC ID 9234022567, 120 clinicians
St Marys Hospital Centralia IllinoisGroup PAC ID 6709788920, 118 clinicians
County of ClayGroup PAC ID 0042101982, 77 clinicians

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (557) 203-1601

2 Good Samaritan Way
Suite 320
Mount Vernon, IL 62864-2408
Phone (618) 899-1944

400 N Pleasant Ave
Centralia, IL 62801-3056
Phone (618) 436-8000

911 Stacey Burk Dr
Flora, IL 62839-3241
Phone (618) 662-2131

Hospital & facility affiliations

  • Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046
  • Clay County Hospital Hospital, Flora, IL, CCN 141351
  • SSM Health St Mary'S Hospital -Centralia Hospital, Centralia, IL, CCN 140034
  • Washington County Hospital Hospital, Nashville, IL, CCN 141308
  • Fairfield Memorial Hospital 1 Hospital, Fairfield, IL, CCN 141311

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57239-21WIMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Clay CurrentSince Jun 18, 2018 Accepting new patients
St. Mary'S Hospital, Centralia, Illinois CurrentSince Jul 1, 2016 Accepting new patients
County of Clay Current Accepting new patients
County of Clay CurrentSince Jun 18, 2018 Accepting new patients
St. Mary'S Hospital, Centralia, Illinois CurrentSince Jul 1, 2016 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

911 Stacey Burk Dr
Flora, IL 62839
Phone (618) 662-2161

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-2200

602 S 42nd St
Ste B
Mount Vernon, IL 62864
Phone (618) 899-3278

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

2 Good Samaritan Way
Ste 220
Mount Vernon, IL 62864
Phone (618) 899-3900

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

Interoperability endpoints

  • Direct secure messaging: bnguyen115920@direct-ehr-ssmhc.com
  • Direct secure messaging: bnguy@yourcarecommunity.org

Organizations & group practices 7

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 6

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": "1177113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1093933665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955860",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631952217",
            "telephone_number": "636-498-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-338-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "BINH",
        "middle_name": "T",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-21",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101016741",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "WI",
            "license": "57239-21",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MI",
            "license": "5101016741",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036135508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bnguyen115920@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bnguyen115920@direct-ehr-ssmhc.com",
            "address_1": "2 Good Samaritan Way Ste 220",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642476",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2 Good Samaritan Way Ste 220",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.