Individual provider Active NPI

Alexander An Quoc Nguyen, MSN, APRN, AGPCNP-BC

  • Nurse Practitioner
  • Annandale, VA
National Provider Identifier
1235846213
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024185156 Issued in VA
Practice address
4208 Evergreen LN Ste 214
Annandale, VA 22003-3254
Phone
(703) 642-6633
NPI assigned
Oct 31, 2022
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024185156 VA Primary

Addresses

Primary practice location

4208 Evergreen LN Ste 214
Annandale, VA 22003-3254

Mailing address

4208 Evergreen LN Ste 214
Annandale, VA 22003-3254
Phone (703) 642-6633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230217000340 DC Practitioner - Nurse Practitioner 6800268913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Connie D. Le, M.D, P.CGroup PAC ID 1052349453, 5 clinicians

Practice addresses (Care Compare)

4208 Evergreen LN
Suite 214
Annandale, VA 22003-3254
Phone (703) 642-6633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024185156VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connie D. Le, M.D, P.C CurrentSince Jan 1, 2023 Accepting new patients

Locations

4208 Evergreen Ln
Ste 214
Annandale, VA 22003
Phone (703) 459-0310

2812 Old Lee Hwy
Ste 210A
Fairfax, VA 22031
Phone (703) 642-6633

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBAACD/Endpoint/CBAACD

Organizations & group practices 1

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": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1235846213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 EVERGREEN LN STE 214",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033254",
            "telephone_number": "703-642-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 EVERGREEN LN STE 214",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033254",
            "telephone_number": "703-642-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ALEXANDER",
        "middle_name": "AN QUOC",
        "credential": "MSN, APRN, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024185156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.