Active NPI
Kimberly Hoang Nguyen, DPM
- Podiatrist
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- SC006424
- Practice address
- 1311 South St
Philadelphia, PA 19147-1867 - Phone
- (215) 471-0433
- Fax
- (215) 471-0430
- NPI assigned
- Jul 12, 2010
- Last updated
- Jan 7, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | SC006424 | PA | Primary |
Addresses
Primary practice location
1311 South St
Philadelphia, PA 19147-1867
Mailing address
1311 South St
Philadelphia, PA 19147-1867
Phone (215) 471-0433
Other practice location 1
715 S 13th St
Philadelphia, PA 19147-1839
Phone (817) 726-1638
Other practice location 2
1930 S Broad St Ste 19
Philadelphia, PA 19145-2328
Phone (215) 471-0433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033277130001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Temple University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1311 S St
Philadelphia, PA 19147-1867
Phone (215) 471-0433
2230 Cottman Ave
Philadelphia, PA 19149-1230
Phone (215) 685-0602
29 Bala Ave
Suite 114
Bala Cynwyd, PA 19004-3206
Phone (215) 471-0433
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of skin lesions | 56 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC006424 | PA | MD | Podiatrist |
| 2087 | TX | MD | Electroneurodiagnostic Specialist/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delta Foot and Ankle Center, LLC | Podiatrist | Current | Accepting new patients |
| City of Philadelphia | Current | Accepting new patients | |
| City of Philadelphia | Current | Accepting new patients | |
| Kimberly Nguyen DPM PC | Podiatrist | Current | Accepting new patients |
| City of Philadelphia | Current | Accepting new patients | |
| Advanced Foot Centre, PA | Podiatrist | Past | Accepting new patients |
Locations
29 Bala Ave
Ste 114
Bala Cynwyd, PA 19004
Phone (484) 278-4308
435 N Broad St
Grove City, PA 16127
Phone (724) 450-7800
647 N Broad Street Ext
Grove City, PA 16127
Phone (724) 450-7004
647 N Broad Street Ext
Ste 101
Grove City, PA 16127
Phone (724) 450-7010
742 N Broad Street Ext
Grove City, PA 16127
Phone (724) 458-6245
1101 Market St
Fl 10
Philadelphia, PA 19107
4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600
224 W Mahoning St
Punxsutawney, PA 15767
Phone (814) 938-1770
Interoperability endpoints
- kimberly.nguyen.1@13539.direct.athenahealth.com
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Health Care Center 2
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1942317094
-
dba Phila Health Dept Laboratory
- Clinical Medical Laboratory
- Phila, PA
- NPI 1689688798
-
dba Health Center 10
- Federally Qualified Health Center (FQHC)
- Philadelphia, PA
- NPI 1699882597
-
- Podiatrist
- Grove City, PA
- NPI 1053651745
-
- Podiatrist
- Spring, TX
- NPI 1629913249
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Phila, PA
- NPI 1063489342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578355200000",
"number": "1144532748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 SOUTH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191471867",
"telephone_number": "215-471-0433",
"fax_number": "215-471-0430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 SOUTH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191471867",
"telephone_number": "215-471-0433",
"fax_number": "215-471-0430"
}
],
"practiceLocations": [
{
"address_1": "715 S 13th St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191471839",
"country_code": "US",
"telephone_number": "817-726-1638",
"fax_number": "215-471-0430",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1930 S Broad St Ste 19",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191452328",
"country_code": "US",
"telephone_number": "215-471-0433",
"fax_number": "215-471-0430",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "KIMBERLY",
"middle_name": "HOANG",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-12",
"last_updated": "2020-01-07",
"certification_date": "2020-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "PA",
"license": "SC006424",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1033277130001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.