Johnny Thanh Nguyen

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

1135 116TH Ave NE Ste 605
Bellevue, WA 98004-4697

Phone

(425) 454-8161

Fax

(425) 454-9304

NPI assigned

Sep 4, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051

Merit-based Incentive Payment System (MIPS)

Final score

86.73 of 100Reported as apm

Quality

73.46

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Overlake Medical Clinics, LLC

  • Specialist
  • Bellevue, WA
  • NPI 1801828421
  Medicare reassignment Care Compare group NPD (past)

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

• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1598971855
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726
  Care Compare affiliation

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1104308394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 605",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044697",
            "telephone_number": "425-454-8161",
            "fax_number": "425-454-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 605",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044697",
            "telephone_number": "425-454-8161",
            "fax_number": "425-454-9304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056367",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "fax_number": "206-616-3889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOHNNY",
        "middle_name": "THANH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-04",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huytuong Vu Nguyen, DC
• James Nguyen
• Jason Nguyen
• Jenny Nguyen
• Jessica V Nguyen, DDS, MPH
• Julie Nguyen
• Kathleen Nguyen
• Khoa V Nguyen, MD
• Lan Hien Nguyen, M.D.
• Lily Tang Nguyen, PHARMD

• Surgical Physician Assistant in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.