Organization Active NPI

Casey Nguyen MD PA

  • Family Medicine Physician
  • Irving, TX
National Provider Identifier
1104863109
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L7825 Issued in TX
Legal business name
CASEY NGUYEN MD PA
Practice address
1420 N Macarthur Blvd
Irving, TX 75061-4409
Phone
(214) 596-9229
Fax
(214) 596-9231
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Casey Nguyen, MDNPI 1700832524
Title
Owner
Phone
(214) 596-9229

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X L7825 TX Primary

Addresses

Primary practice location

1420 N Macarthur Blvd
Irving, TX 75061-4409

Mailing address

1420 N Macarthur Blvd
Irving, TX 75061-4409
Phone (214) 596-9229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060130000495 TX Part B Supplier - Clinic/Group Practice 8123032158 Receives reassigned benefits from 1 practitioner
Practice locations: Irving, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1050052Casey Nguyen MD,PA1420 North Macarthur, Irving, TX 75061Certificate of waiverJan 23, 2028

National Provider Directory

National Provider Directory

Locations

1420 N MacArthur Blvd
Irving, TX 75061
Phone (214) 596-9229

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104863109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750614409",
            "telephone_number": "214-596-9229",
            "fax_number": "214-596-9231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750614409",
            "telephone_number": "214-596-9229",
            "fax_number": "214-596-9231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASEY NGUYEN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-596-9229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L7825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.