Individual provider Active NPI

Johnny Nguyen DO, M.D.

  • Internal Medicine Physician
  • Orange, CA
National Provider Identifier
1235371675
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A107046 Issued in CA
Practice address
1100 W Stewart Dr
Orange, CA 92868-3849
Phone
(714) 771-8000
NPI assigned
Mar 31, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60335318 WA
Pediatrics Physician 208000000X MD60335318 WA
Hospitalist Physician 208M00000X MD60335318 WA
Internal Medicine Physician 207R00000X A107046 CA Primary

Addresses

Primary practice location

1100 W Stewart Dr
Orange, CA 92868-3849

Mailing address

5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone (509) 868-0876

Other practice location 1

5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone (509) 868-0876

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdo1373389@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20150918000346 CA Practitioner - Internal Medicine 0042453359 Reassigns benefits to 2 organizations
I20250220003244 OR Practitioner - Internal Medicine 0042453359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Eastern Virginia Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

200 W Ctr St Promenade
Anaheim, CA 92805-3960

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107046CAMDMarriage & Family Therapist
MD60335318WAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Jan 10, 2025 Accepting new patients
Providence Medical Foundation CurrentSince Aug 1, 2016 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Healthcare Crossing Corporation Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
Providence Medical Foundation CurrentSince Aug 1, 2016 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Jan 10, 2025 Accepting new patients
Inpatient Consultants of California, Inc. Internal Medicine Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

39765 Date St
Ste 100
Murrieta, CA 92563
Phone (951) 279-0100

39765 Date St
Ste 102
Murrieta, CA 92563

845 W La Veta Ave
Ste 105
Orange, CA 92868
Phone (714) 289-6565

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

2501 E Chapman Ave
#311
Orange, CA 92869

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

Interoperability endpoints

  • Direct secure messaging: jdo1373389@oc.providencedirect.org

Organizations & group practices 8

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.

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": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1235371675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5633 N LIDGERWOOD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081224",
            "telephone_number": "509-868-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W STEWART DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683849",
            "telephone_number": "714-771-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5633 N Lidgerwood St",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992081224",
            "country_code": "US",
            "telephone_number": "509-868-0876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DO",
        "first_name": "JOHNNY",
        "middle_name": "NGUYEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-31",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60335318",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60335318",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD60335318",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A107046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdo1373389@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2501 E Chapman Ave # 311",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928693204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.