Individual provider Active NPI

Julie Nguyen, DO

  • Obstetrics & Gynecology Physician
  • Pontiac, MI
National Provider Identifier
1104073014
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101017948 Issued in MI
Practice address
44405 Woodward Ave
Pontiac, MI 48341-5023
Phone
(248) 858-6272
NPI assigned
Aug 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101017948 MI Primary

Addresses

Primary practice location

44405 Woodward Ave
Pontiac, MI 48341-5023

Mailing address

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-6272

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121114000327 CA Practitioner - Obstetrics/Gynecology 1850542135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101017948MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Obstetrics & Gynecology Current Accepting new patients
Permanente Medical Group Inc Obstetrics & Gynecology CurrentSince Jul 28, 2014 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jul 28, 2014 Accepting new patients
Jo Taylor, M.D., Inc Obstetrics & Gynecology PastSince Jul 1, 2007 Accepting new patients

Locations

9201 Big Horn Blvd
Elk Grove, CA 95758
Phone (916) 478-5000

1800 Harrison St
Fl 7
Oakland, CA 94612

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 4

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": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1104073014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JULIE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-21",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101017948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9201 Big Horn Blvd",
            "city": "Elk Grove",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.