Individual provider Active NPI

Michael Ong Nguyen, MD

  • Dermatology Physician
  • Encino, CA
National Provider Identifier
1174028138
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A164715 Issued in CA
Practice address
15503 Ventura Blvd
Encino, CA 91436-3114
Phone
(818) 461-8148
Fax
(818) 461-8105
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A164715 CA Primary

Addresses

Primary practice location

15503 Ventura Blvd
Encino, CA 91436-3114

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220721001308 CA Practitioner - Dermatology 3274964051 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Harvard Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 8426956160, 33 clinicians

Practice addresses (Care Compare)

100 Medical Plaza
Suite 216
Los Angeles, CA 90095-0001
Phone (310) 206-8662

100 Moody CT
Suite 200
Thousand Oaks, CA 91360-6082
Phone (805) 418-3500

15503 Ventura Blvd
Encino, CA 91436-3114
Phone (818) 461-8148

200 Medical Plaza
Los Angeles, CA 90095-0001
Phone (310) 825-6911

2001 Santa Monica Blvd
Suite 1070
Santa Monica, CA 90404-2202
Phone (310) 917-3376

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

2020 Santa Monica Blvd
Suite 510
Santa Monica, CA 90404-2131
Phone (310) 582-6360

2625 W Alameda Ave
Suite 322
Burbank, CA 91505-4822
Phone (818) 843-9015

2780 Skypark Dr
Suite 125
Torrance, CA 90505-7528
Phone (310) 530-8001

757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 267-9643

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
89.72
Promoting interoperability
100
Improvement activities
40
Cost
67.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision22
Removal of skin lesions658
Removal or shaving of skin growth1-10
Skin biopsy182

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A164715CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Sep 1, 2022 Accepting new patients
The Regents of the University of California CurrentSince Sep 1, 2022 Accepting new patients
The Regents of the University of California Dermatology CurrentSince Sep 1, 2022 Accepting new patients
UCLA Medical Group Dermatology Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

15503 Ventura Blvd
Ste 240
Encino, CA 91436
Phone (310) 825-7163

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

200 Medical Plz
Ste 465
Los Angeles, CA 90095
Phone (310) 825-5510

200 UCLA Medical Plz
Ste 450
Los Angeles, CA 90095
Phone (310) 825-6911

File 55737
Los Angeles, CA 90074

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

2001 Santa Monica Blvd
Ste 1070
Santa Monica, CA 90404
Phone (310) 315-7900

2020 Santa Monica Blvd
Ste 510
Santa Monica, CA 90404
Phone (310) 633-8400

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

Interoperability endpoints

  • Direct secure messaging: mnguyen1031871@direct.uclahealth.org

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 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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1174028138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15503 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914363114",
            "telephone_number": "818-461-8148",
            "fax_number": "818-461-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MICHAEL",
        "middle_name": "ONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A164715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.