NPIMap

Individual provider Active NPI

Dan Kim Nguyen, PA-C

  • Physician Assistant
  • Fall River, MA
National Provider Identifier
1194808691
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1237 Issued in MA
Practice address
528 Newton Street
Tru-Med Walk-in
Fall River, MA 02721
Phone
(508) 675-1522
NPI assigned
Oct 20, 2006
Last updated
Jan 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1237 MA Primary

Addresses

Primary practice location

528 Newton Street
Tru-Med Walk-in
Fall River, MA 02721

Mailing address

528 Newton Street
Tru-Med Walk-in
Fall River, MA 02721

Other practice location 1

117 Albany Turnpike
Canton, CT 06019
Phone (860) 658-8750

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dnguyen31800@direct.med.uchc.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210521002217 CT Practitioner - Physician Assistant 1456395334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

120 Dowling Way
Uconn Health Ancillary SVCS
Farmington, CT 06030-3800
Phone (860) 679-2784

135 Dowling Way
Farmington, CT 06030-3800
Phone (860) 679-2784

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince Jul 16, 2021 Accepting new patients
State of Connecticut CurrentSince Jul 16, 2021 Accepting new patients
DO Not Use - the Lowell General Hospital Past Accepting new patients
The Lowell General Hospital Past Accepting new patients
LGH Professional Services LLC Past Accepting new patients
LGH Physician Associates, Inc Past Accepting new patients

Locations

117 Albany Tpke
Canton, CT 06019
Phone (860) 658-3444

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d04f75c7-2a62-4686-b520-7bf0635f38f0/

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 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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1194808691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 NEWTON STREET",
            "address_2": "TRU-MED WALK-IN",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 NEWTON STREET",
            "address_2": "TRU-MED WALK-IN",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02721",
            "telephone_number": "508-675-1522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Albany Turnpike",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "CT",
            "postal_code": "06019",
            "country_code": "US",
            "telephone_number": "860-658-8750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DAN",
        "middle_name": "KIM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dnguyen31800@direct.med.uchc.edu",
            "affiliation": "N",
            "endpointDescription": "UConn",
            "address_1": "117 Albany Turnpike",
            "city": "Canton",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.