Individual provider Active NPI

Derek Nguyen

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1205457074
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0078420 Issued in CO
Practice address
3055 Roslyn St Unit 100
Denver, CO 80238-3324
Phone
(720) 553-2696
NPI assigned
May 2, 2020
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0078420 CO Primary

Addresses

Primary practice location

3055 Roslyn St Unit 100
Denver, CO 80238-3324

Mailing address

3055 Roslyn St Unit 100
Denver, CO 80238-3324
Phone (720) 553-2696

Other practice location 1

800 Stanton L Young Blvd
Oklahoma City, OK 73104-5018
Phone (405) 271-2316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20230707001345 CO Order and Referring Only - Family PracticePractitioner - Family Practice 1951760040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TL.0009856COMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1588377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1205457074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 ROSLYN ST UNIT 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802383324",
            "telephone_number": "720-553-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 ROSLYN ST UNIT 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802383324",
            "telephone_number": "720-553-2696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Stanton L Young Blvd",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045018",
            "country_code": "US",
            "telephone_number": "405-271-2316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-02",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0078420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.