Individual provider Active NPI

Michael Nguyen, DO

  • Pediatric Cardiology Physician
  • Capitola, CA
National Provider Identifier
1225491764
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
20A24557 Issued in CA
Practice address
824 Bay Ave Ste 70
Capitola, CA 95010-2104
Phone
(831) 457-2361
Fax
(831) 457-2882
NPI assigned
Apr 1, 2016
Last updated
Feb 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR.0061983 CO
Pediatrics Physician 208000000X 20A24557 CA
Pediatric Cardiology Physician 2080P0202X 10311 AZ
Pediatric Cardiology Physician 2080P0202X DR.0061983 CO
Pediatric Cardiology Physician 2080P0202X 20A24557 CA Primary

Addresses

Primary practice location

824 Bay Ave Ste 70
Capitola, CA 95010-2104

Mailing address

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Other practice location 1

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-1000

Other identifiers 2

IdentifierTypeStateIssuer
142150MedicaidAZ
1225491764MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230831000568 AZ Practitioner - Cardiovascular Disease (Cardiology) 6709119217 Reassigns benefits to 2 organizations
I20251028000770 TX Practitioner - Pediatric Medicine 6709119217
I20251223002275 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 6709119217 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Midwestern University, Chicago College of Osteopathic Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children's HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24557CAMDClinical Social Worker
10311AZMDPediatric Cardiology Physician
20A24557CAMDPediatric Cardiology Physician
DR.0061983COMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Mar 30, 2024 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Feb 23, 2025 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince Dec 10, 2025 Accepting new patients
District Medical Group, Inc CurrentSince Mar 30, 2024 Accepting new patients
Stanford Health Care Pediatrics CurrentSince Dec 10, 2025 Accepting new patients
Phoenix Children's Medical Group CurrentSince Aug 1, 2023 Accepting new patients
Stanford Health Care CurrentSince Dec 10, 2025 Accepting new patients
Phoenix Children's Hospital Pediatrics Current Accepting new patients
Phoenix Children's Hospital Past Accepting new patients
Phoenix Children's Hospital Past Accepting new patients

Locations

5130 N US Highway 89
Flagstaff, AZ 86004
Phone (928) 773-2054

3370 S Mercy Rd
Ste 221
Gilbert, AZ 85297

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: mnguyen264809@direct.valleywisehealth.org

Organizations & group practices 12

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": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1225491764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 BAY AVE STE 70",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102104",
            "telephone_number": "831-457-2361",
            "fax_number": "831-457-2882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167710",
            "country_code": "US",
            "telephone_number": "602-933-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0061983",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A24557",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AZ",
            "license": "10311",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CO",
            "license": "DR.0061983",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "20A24557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142150",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225491764",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitola, CA

Sources for this page

Verify at the official NPI Registry.