Individual provider Active NPI

Annie Lan Anh Nguyentat, DPM

  • Podiatrist
  • Mountain View, CA
National Provider Identifier
1134486160
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E5124 Issued in CA
Practice address
701 E El Camino Real
Mountain View, CA 94040-2833
Phone
(650) 934-7090
NPI assigned
Apr 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E5124 CA Primary

Addresses

Primary practice location

701 E El Camino Real
Mountain View, CA 94040-2833

Mailing address

2350 W El Camino Real
2ND Floor
Mountain View, CA 94040-6201

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140724001192 CA Practitioner - Podiatry 2163648379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Roseville Orthopedic Group a Medical CorpGroup PAC ID 5193790046, 4 clinicians

Practice addresses (Care Compare)

151 N Sunrise Ave
Suite 1005
Roseville, CA 95661-2930
Phone (916) 782-1217

Hospital & facility affiliations

  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498

Merit-based Incentive Payment System (MIPS)

Final score
93.3 of 100Reported as group
Quality
99.8
Promoting interoperability
100
Improvement activities
40
Cost
77.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue12
Removal of skin lesions1-10
Removal of nail tissue14
Removal or shaving of skin growth141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5124CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Roseville Orthopedic Group a Medical Corp CurrentSince Sep 1, 2015 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
El Camino Hospital Past Accepting new patients

Locations

220 Standiford Ave
Ste F
Modesto, CA 95350
Phone (209) 589-1500

151 N Sunrise Ave
Ste 1005
Roseville, CA 95661
Phone (916) 782-1217

Interoperability endpoints

  • Direct secure messaging: anguyentat205061@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 3

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": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1134486160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E EL CAMINO REAL",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402833",
            "telephone_number": "650-934-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYENTAT",
        "first_name": "ANNIE",
        "middle_name": "LAN ANH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.