NPIMap

Individual provider Active NPI

Phuong L Nguyen, PA-C

  • Medical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1245487693
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA1118 Issued in NV
Practice address
4475 S Eastern Ave
Las Vegas, NV 89119-7826
Phone
(702) 877-5199
NPI assigned
Aug 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1118 NV Primary

Addresses

Primary practice location

4475 S Eastern Ave
Las Vegas, NV 89119-7826

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 877-5199

Other identifiers 2

IdentifierTypeStateIssuer
1245487693MedicaidNV
P00892335OtherNVRAILROAD MEDICARE

Other names 1

  • Phuong L Nguyen-Pham Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090112000074 NV Practitioner - Physician Assistant 9931262391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Group II Rhodes P CGroup PAC ID 4981687779, 296 clinicians

Practice addresses (Care Compare)

4475 S Eastern Ave
Las Vegas, NV 89119-7826
Phone (702) 579-3253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Hills Medical Center, LLC Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
Desert View Regional Medical Center Holdings, LLC Past Accepting new patients
Intermountain Medical Holdings Nevada Inc Past Accepting new patients
North Vista Hospital LLC Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Dignity Health Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Maisto Family Medical, LTD. Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Henderson Hospital Past Accepting new patients
De Craig Ranch, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pnguyen121000@westdirect.optum.com
  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

Organizations & group practices 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1245487693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-877-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197826",
            "telephone_number": "702-877-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUONG",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245487693",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00892335",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHUONG",
            "last_name": "NGUYEN-PHAM",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.