Individual provider Active NPI

Anna Ngoc Nguyen, M.D.

  • Emergency Medicine Physician
  • Berwyn, IL
National Provider Identifier
1235422882
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A124222 Issued in CA
Practice address
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone
(708) 783-6000
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036138247 IL
Emergency Medicine Physician 207P00000X A124222 CA Primary

Addresses

Primary practice location

3249 Oak Park Ave
Berwyn, IL 60402-3429

Mailing address

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (916) 734-8571

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
I20141003000823 CA Practitioner - Emergency Medicine 3274753710 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 781-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A124222CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity-California Observation Services PC Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Sep 1, 2016 Accepting new patients
Vituity-California Observation Services PC Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Sep 1, 2016 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

Interoperability endpoints

  • Direct secure messaging: anguyen212771@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1235422882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "916-734-8571",
            "fax_number": "916-734-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "708-783-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANNA",
        "middle_name": "NGOC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036138247",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A124222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.