Individual provider Active NPI

Kimberly Hoang Nguyen, DPM

  • Podiatrist
  • Philadelphia, PA
National Provider Identifier
1144532748
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC006424 Issued in PA
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, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1033277130001MedicaidPA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171017001255 PA Practitioner - Podiatry 5092932228 Reassigns benefits to 2 organizations

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
Kimberly Nguyen DPM PCGroup PAC ID 0547696544, 2 clinicians
City of PhiladelphiaGroup PAC ID 6305758723, 86 clinicians

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

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006424PAMDPodiatrist
2087TXMDElectroneurodiagnostic Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Foot and Ankle Center, LLC Podiatrist CurrentSince Aug 6, 2017 Accepting new patients
City of Philadelphia CurrentSince Jul 15, 2019 Accepting new patients
City of Philadelphia CurrentSince Jul 15, 2019 Accepting new patients
Kimberly Nguyen DPM PC Podiatrist CurrentSince Dec 20, 2019 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.