Individual provider Active NPI

Tai Anh Nguyen

  • Family Medicine Physician
  • Metairie, LA
National Provider Identifier
1275823916
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
207302 Issued in LA
Practice address
3848 Veterans Memorial Blvd
Suite 101
Metairie, LA 70002-5671
Phone
(504) 885-2505
NPI assigned
Apr 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 207302 LA Primary

Addresses

Primary practice location

3848 Veterans Memorial Blvd
Suite 101
Metairie, LA 70002-5671

Mailing address

3848 Veterans Memorial Blvd
Suite 101
Metairie, LA 70002-5671
Phone (504) 885-2505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20141024000600 LA Practitioner - Family Practice 8325269947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Jefferson Family Practice L.L.C.Group PAC ID 7517981772, 4 clinicians

Practice addresses (Care Compare)

3848 Veterans Memorial Blvd
Suite 101
Metairie, LA 70002-5636
Phone (504) 885-2505

Hospital & facility affiliations

  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207302LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Jefferson Family Practice L.L.C. Family Medicine CurrentSince Aug 15, 2014 Accepting new patients

Locations

3848 Veterans Memorial Blvd
Ste 101
Metairie, LA 70002
Phone (504) 473-8435

2109 David Dr
Metairie, LA 70003
Phone (504) 885-2505

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1275823916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3848 VETERANS MEMORIAL BLVD",
            "address_2": "SUITE 101",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700025671",
            "telephone_number": "504-885-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3848 VETERANS MEMORIAL BLVD",
            "address_2": "SUITE 101",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700025671",
            "telephone_number": "504-885-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TAI",
        "middle_name": "ANH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-14",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "207302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.