Individual provider Active NPI

Vincent Gia Nguyen, DO

  • Internal Medicine Physician
  • Scotts Valley, CA
National Provider Identifier
1285212704
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23178 Issued in CA
Practice address
245 Mount Hermon Rd Ste L
Scotts Valley, CA 95066-4044
Phone
(831) 430-7203
Fax
(831) 430-7204
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23178 CA Primary

Addresses

Primary practice location

245 Mount Hermon Rd Ste L
Scotts Valley, CA 95066-4044

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250107001619 CA Practitioner - Internal Medicine 8123429958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

245 Mount Hermon Rd
Suite L
Scotts Valley, CA 95066-4044
Phone (831) 430-7203

Hospital & facility affiliations

  • Mission Home Health of Monterey Home health agency, Monterey, CA, CCN 059726
  • Dominican Hospital Hospital, Santa Cruz, CA, CCN 050242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23178CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Jan 6, 2025 Accepting new patients
Dignity Health Medical Foundation CurrentSince Jan 6, 2025 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

1595 Soquel Dr
Ste 400
Santa Cruz, CA 95065
Phone (831) 475-1111

245 Mount Hermon Rd
Ste L
Scotts Valley, CA 95066
Phone (831) 430-7203

Organizations & group practices 4

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1285212704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MOUNT HERMON RD STE L",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664044",
            "telephone_number": "831-430-7203",
            "fax_number": "831-430-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VINCENT",
        "middle_name": "GIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "23178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scotts Valley, CA

Sources for this page

Verify at the official NPI Registry.