Individual provider Active NPI

Dai Dao Nghiem, MD

  • Transplant Surgery Physician
  • Sacramento, CA
National Provider Identifier
1285635672
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
C52961 Issued in CA
Practice address
2315 Stockton Blvd # 2021
UC Davis Medical Center
Sacramento, CA 95817-2201
Phone
(916) 734-7882
Fax
(916) 734-6564
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD037728E PA
Transplant Surgery Physician 204F00000X MD-037728-E PA
Transplant Surgery Physician 204F00000X C52961 CA Primary

Addresses

Primary practice location

2315 Stockton Blvd # 2021
UC Davis Medical Center
Sacramento, CA 95817-2201

Mailing address

2315 Stockton Blvd # 2021
UC Davis Medical Center
Sacramento, CA 95817-2201
Phone (916) 734-7882

Other identifiers 3

IdentifierTypeStateIssuer
0165744MedicaidOH
0222598000MedicaidWV
0010746440001MedicaidPA

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
I20110524000543 CA Practitioner - Family PracticePractitioner - General SurgeryPractitioner - Other (Physician) 6204012487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dao Medical Group IncGroup PAC ID 2466687728, 12 clinicians

Practice addresses (Care Compare)

9191 Westminster Ave
Garden Grove, CA 92844-2751
Phone (714) 899-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52961CAMDTransplant Surgery Physician
MD-037728-EPAMDTransplant Surgery Physician
MD037728EPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients
West Penn Allegheny Health System Inc. Past Accepting new patients
Regents of the Univ of Ca Surgery Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1285635672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD # 2021",
            "address_2": "UC DAVIS MEDICAL CENTER",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-7882",
            "fax_number": "916-734-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD # 2021",
            "address_2": "UC DAVIS MEDICAL CENTER",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-7882",
            "fax_number": "916-734-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGHIEM",
        "first_name": "DAI",
        "middle_name": "DAO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD037728E",
            "primary": false
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "PA",
            "license": "MD-037728-E",
            "primary": false
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "CA",
            "license": "C52961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0165744",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0222598000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010746440001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.