Individual provider Active NPI

Suong Thu Nguyen, PA

  • Physician Assistant
  • Hampton, VA
National Provider Identifier
1255716577
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006187 Issued in VA
Practice address
4000 Coliseum Dr Ste 200
Hampton, VA 23666-5975
Phone
(757) 736-8050
Fax
(757) 736-8080
NPI assigned
Jul 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110006187 VA Primary

Addresses

Primary practice location

4000 Coliseum Dr Ste 200
Hampton, VA 23666-5975

Mailing address

4000 Coliseum Dr Ste 200
Hampton, VA 23666-5975
Phone (757) 736-8050

Other practice location 1

3636 High St
Portsmouth, VA 23707-3236
Phone (757) 398-2285

Other names 1

  • Suong Thu Nguyen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20191028000808 VA Practitioner - Physician Assistant 2365774213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

100 Sentara Cir
Williamsburg, VA 23188-5713

100 Sentara Circle
SMG Division of Hospital Medicine William
Wiliamsburg, VA 23188-5713
Phone (757) 984-7217

3000 Coliseum Dr
Hampton, VA 23666-5963

4000 Coliseum Dr
Hampton, VA 23666-5983

830 Kempsville Rd
2B223
Norfolk, VA 23502-3920
Phone (757) 261-8860

850 Kempsville Rd
Norfolk, VA 23502-3920

Hospital & facility affiliations

  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110006187VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Sentara Medical Group CurrentSince Jul 12, 2021 Accepting new patients

Locations

4000 Coliseum Dr
Ste 200
Hampton, VA 23666
Phone (757) 736-8050

4001 Coliseum Dr
Ste 200
Hampton, VA 23666
Phone (757) 736-8050

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

Organizations & group practices 2

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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1255716577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 COLISEUM DR STE 200",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665975",
            "telephone_number": "757-736-8050",
            "fax_number": "757-736-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 COLISEUM DR STE 200",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665975",
            "telephone_number": "757-736-8050",
            "fax_number": "757-736-8080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3636 High St",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237073236",
            "country_code": "US",
            "telephone_number": "757-398-2285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "SUONG",
        "middle_name": "THU",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUONG",
            "last_name": "NGUYEN",
            "middle_name": "THU",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.