Individual provider Active NPI

Khoa V Nguyen, MD

  • Internal Medicine Physician
  • Bellevue, WA
National Provider Identifier
1154337137
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00037474 Issued in WA
Practice address
1035 116TH Ave NE Ste 117
Bellevue, WA 98004-4604
Phone
(425) 688-5000
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00037474 WA Primary

Addresses

Primary practice location

1035 116TH Ave NE Ste 117
Bellevue, WA 98004-4604

Mailing address

1035 116TH Ave NE Ste 117
Bellevue, WA 98004-4604
Phone (425) 688-5000

Other practice location 1

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone (253) 403-1590

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100520001000 WA Practitioner - Internal Medicine 7618006107 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5072

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 8, 2019 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Jun 27, 2016 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 8, 2019 Accepting new patients
Multicare Health System CurrentSince Sep 1, 1999 Accepting new patients
Multicare Health System CurrentSince Sep 1, 1999 Accepting new patients
Multicare Health System Current Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Overlake Medical Center & Clinics Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

1035 116th Ave NE
Ste 117
Bellevue, WA 98004

32114 1st Ave S
Ste 103
Federal Way, WA 98003
Phone (253) 403-7277

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

11511 NE 10th St
Hunts Point, WA 98004
Phone (425) 502-3000

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 10

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 2

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1154337137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE STE 117",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-688-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE STE 117",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-688-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Martin Luther King Jr Way",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054234",
            "country_code": "US",
            "telephone_number": "253-403-1590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KHOA",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00037474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1035 116th Ave NE Ste 117",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980044604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.