Individual provider Active NPI

Diane Thuy Tu Nguyen, MD

  • Family Medicine Physician
  • Westminster, CA
National Provider Identifier
1225065428
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A84273 Issued in CA
Practice address
10362 Bolsa Avenue
Bolsa Medical Group
Westminster, CA 92683-6763
Phone
(714) 531-2091
Fax
(714) 531-1403
NPI assigned
Jun 26, 2006
Last updated
Dec 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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 A84273 CA Primary

Addresses

Primary practice location

10362 Bolsa Avenue
Bolsa Medical Group
Westminster, CA 92683-6763

Mailing address

10362 Bolsa Avenue
Bolsa Medical Group
Westminster, CA 92683-6763
Phone (714) 531-2091

Other identifiers 1

IdentifierTypeStateIssuer
00A842730MedicaidCA

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
I20051207000946 CA Practitioner - Family Practice 7214904663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Hahnemann University College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bolsa Medical GroupGroup PAC ID 2769458264, 14 clinicians

Practice addresses (Care Compare)

10362 Bolsa Ave
Westminster, CA 92683-6763
Phone (714) 531-2091

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A84273CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bolsa Medical Group Family Medicine CurrentSince Feb 2, 2016 Accepting new patients
Bolsa Medical Group Past Accepting new patients

Locations

10362 Bolsa Ave
Westminster, CA 92683
Phone (714) 531-2091

10362 Bolsa Ave
Ste 110
Westminster, CA 92683
Phone (714) 531-2091

10362 Bolsa Ave
Ste 211
Westminster, CA 92683

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: diane.nguyen@bolsamg.directbygreenway.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1225065428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10362 BOLSA AVENUE",
            "address_2": "BOLSA MEDICAL GROUP",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836763",
            "telephone_number": "714-531-2091",
            "fax_number": "714-531-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10362 BOLSA AVENUE",
            "address_2": "BOLSA MEDICAL GROUP",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836763",
            "telephone_number": "714-531-2091",
            "fax_number": "714-531-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DIANE",
        "middle_name": "THUY TU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A84273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A842730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.