Individual provider Active NPI

Haidang Dang Nguyen, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1265069470
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
319088-01 Issued in NY
Practice address
330 W 58TH St Ste 414
New York, NY 10019-1819
Phone
(212) 624-0220
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA12384900 NJ
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 319088-01 NY Primary

Addresses

Primary practice location

330 W 58TH St Ste 414
New York, NY 10019-1819

Mailing address

330 W 58TH St Ste 414
New York, NY 10019-1819
Phone (212) 624-0220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20251230001567 NY Practitioner - Pediatric Medicine 0749776706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Michigan State University College of Human Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

265 Sunrise Hwy
Suite 20
Rockville Centre, NY 11570

5555 Glenridge Connector
Suite 700
Atlanta, GA 30342-1681

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
319088NYMDLicensed Practical Nurse
25MA12384900NJMDPediatrics Physician
319088-01NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bodhi Medical Care, LLC Single Specialty CurrentSince Nov 12, 2023 Accepting new patients
North Shore Lij, Urgent Care, P.C. Single Specialty CurrentSince Nov 4, 2025 Accepting new patients
Rutgers Robert Wood Johnson Medical School PastSince Mar 1, 2020 Accepting new patients
PM Pediatrics PC Single Specialty Past Accepting new patients
PM Pediatrics of Mamaroneck Single Specialty Past Accepting new patients
PM Pediatrics of Bayside PLLC Single Specialty Past Accepting new patients

Locations

5828 99th St
Flushing, NY 11368
Phone (718) 502-9867

1332 Peninsula Blvd
Hewlett, NY 11557
Phone (516) 531-6130

1436 Union Tpke
New Hyde Park, NY 11040
Phone (516) 360-3631

315 W 57th St
Ste 404
New York, NY 10019
Phone (888) 603-0993

302 E 72nd St
New York, NY 10021
Phone (212) 734-4488

330 W 58th St
Ste 414
New York, NY 10019
Phone (212) 624-0220

377 S Oyster Bay Rd
Plainview, NY 11803
Phone (516) 537-9061

Interoperability endpoints

  • Direct secure messaging: haidang.nguyen@ghuc.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1265069470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 414",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191819",
            "telephone_number": "212-624-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 414",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191819",
            "telephone_number": "212-624-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HAIDANG",
        "middle_name": "DANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA12384900",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "319088-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.