An Tam Thi Nguyen, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

55765 Issued in CA

Practice address

901 San Bernardino Rd Ste 102
Upland, CA 91786-4988

Phone

(909) 579-6721

Fax

(909) 579-6737

NPI assigned

Jun 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synergy CT Surgery PartnershipGroup PAC ID 5698939957, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Temecula Valley Hospital Hospital, Temecula, CA, CCN 050775
• Riverside Community Hospital Hospital, Riverside, CA, CCN 050022
• San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Synergy CT Surgery Partnership

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Upland, CA
  • NPI 1366711236
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Riverside Healthcare System, L.P.

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1114971660
  Care Compare affiliation
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  Care Compare affiliation
• Temecula Valley Hospital Inc

  • General Acute Care Hospital
  • Temecula, CA
  • NPI 1679816201
  Care Compare affiliation

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1295229235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SAN BERNARDINO RD STE 102",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864988",
            "telephone_number": "909-579-6721",
            "fax_number": "909-579-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAN BERNARDINO RD STE 102",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864988",
            "telephone_number": "909-579-6721",
            "fax_number": "909-579-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "AN TAM",
        "middle_name": "THI",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "1382",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "55765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Hope Hospice, Inc.
• Marisa Newman
• Caleb NG
• Binh T. Ngo, D.M.D.
• Phoebie Ngo
• Anlanh-Jennifer Nguyen, PA-C
• Cindy Nguyen, OD
• Lethuy T Nguyen, O.D.
• Phuong Kim Nguyen
• Tammy Nguyen

• Surgical Physician Assistant in Upland, CA
• Providers in Upland, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.