Individual provider Active NPI

Derek Cao Nguyen

  • Physical Therapist
  • Garden Grove, CA
National Provider Identifier
1194606558
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
308577 Issued in CA
Practice address
12372 Gamma St
Garden Grove, CA 92840-3549
Phone
(657) 944-9290
NPI assigned
Sep 10, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 308577 CA Primary

Addresses

Primary practice location

12372 Gamma St
Garden Grove, CA 92840-3549

Mailing address

12372 Gamma St
Garden Grove, CA 92840-3549
Phone (657) 944-9290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251027004567 CA Practitioner - Physical Therapist in Private Practice 1456840800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Global Physical Therapy and WellnessGroup PAC ID 5890103162, 14 clinicians

Practice addresses (Care Compare)

12131 Brookhurst St
Suite B
Garden Grove, CA 92840-2863
Phone (714) 360-8828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
308577CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Global Physical Therapy and Wellness CurrentSince Sep 22, 2025 Accepting new patients
Global Physical Therapy and Wellness Physical Therapist CurrentSince Sep 22, 2025 Accepting new patients

Locations

12131 Brookhurst St
Ste B
Garden Grove, CA 92840
Phone (714) 360-8828

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1194606558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12372 GAMMA ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928403549",
            "telephone_number": "657-944-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12372 GAMMA ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928403549",
            "telephone_number": "657-944-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DEREK",
        "middle_name": "CAO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "308577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.