NPIMap

Individual provider Active NPI

Bac X Nguyen, MD

  • Family Medicine Physician
  • Glassboro, NJ
National Provider Identifier
1295700326
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA07262300 Issued in NJ
Practice address
1120 Delsea Dr N
Glassboro, NJ 08028-1444
Phone
(856) 582-0500
Fax
(856) 218-9607
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA07262300 NJ Primary

Addresses

Primary practice location

1120 Delsea Dr N
Glassboro, NJ 08028-1444

Mailing address

1120 Delsea Dr N
Glassboro, NJ 08028-1444
Phone (856) 582-0500

Other identifiers 2

IdentifierTypeStateIssuer
8628602MedicaidNJ
700594OtherNJMEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050201000654 NJ Practitioner - Family Practice 1355392986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Warren Alpert Medical School of Brown University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

155 Bridgeton Pike
Suite a
Mullica Hill, NJ 08062-2639
Phone (856) 223-0500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Health Network Medical Group, P.C. CurrentSince Jun 1, 2013 Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients
Monmouth Medical Association PC Past Accepting new patients
Kenneth Faistl, MD,PA Family Medicine PastSince Mar 13, 2009 Accepting new patients

Locations

1120 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 205-7071

34 Colson Ln
Mullica Hill, NJ 08062
Phone (856) 223-0500

155 Bridgeton Pike
Ste A
Mullica Hill, NJ 08062
Phone (856) 223-0500

700 Mullica Hill Rd
Mullica Hill, NJ 08062
Phone (856) 508-1000

1 W Broad St
Paulsboro, NJ 08066
Phone (856) 223-0436

798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161

17 W Red Bank Ave
Ste 104
Woodbury, NJ 08096
Phone (856) 848-0665

75 W Red Bank Ave
Woodbury, NJ 08096
Phone (856) 853-2055

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 7

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1295700326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 DELSEA DR N",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080281444",
            "telephone_number": "856-582-0500",
            "fax_number": "856-218-9607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 DELSEA DR N",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080281444",
            "telephone_number": "856-582-0500",
            "fax_number": "856-218-9607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "BAC",
        "middle_name": "X",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA07262300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8628602",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "700594",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glassboro, NJ

Sources for this page

Verify at the official NPI Registry.