Individual provider Active NPI

Ngoc Diep Thi Nguyen, MPAS, PA-C

  • Surgical Physician Assistant
  • Colleyville, TX
National Provider Identifier
1124057633
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
3901 Treemont Cir
Colleyville, TX 76034
Phone
(972) 975-0079
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary
Medical Physician Assistant 363AM0700X

Addresses

Primary practice location

3901 Treemont Cir
Colleyville, TX 76034

Mailing address

1919 Hope Way
Dallas, TX 75206-8177
Phone (972) 975-0079

Other practice location 1

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-3000

Other identifiers 1

IdentifierTypeStateIssuer
PA0445OtherTXTEXAS MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Robotic and Surgical Assistants Surgical CurrentSince Mar 1, 2013 Accepting new patients
Surgical Assistants of Dallas Supplies, LLC Surgical Past Accepting new patients
Lancaster Emergency Physicians, LLC Past Accepting new patients
Mesquite Physicians Group, PLLC Past Accepting new patients
Surgical Assisting Services, PLLC Surgical Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1504/brand/5/csg/87/fhir/r4

Organizations & group practices 5

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1124057633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 HOPE WAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752068177",
            "telephone_number": "972-975-0079",
            "fax_number": "972-863-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 TREEMONT CIR",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "76034",
            "telephone_number": "972-975-0079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NGOC DIEP",
        "middle_name": "THI",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL LICENSE",
            "identifier": "PA0445",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colleyville, TX

Sources for this page

Verify at the official NPI Registry.