Individual provider Active NPI

Trung Minh Nguyen, M.D.

  • Ophthalmology Physician
  • Fountain Valley, CA
National Provider Identifier
1316941966
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G079014 Issued in CA
Practice address
11180 Warner Ave
Ste 151
Fountain Valley, CA 92708-7515
Phone
(714) 444-0303
Fax
(714) 444-2047
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G079014 CA Primary

Addresses

Primary practice location

11180 Warner Ave
Ste 151
Fountain Valley, CA 92708-7515

Mailing address

11180 Warner Ave
Ste 151
Fountain Valley, CA 92708-7515
Phone (714) 444-0303

Other identifiers 1

IdentifierTypeStateIssuer
00G790140MedicaidCA

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
I20110308000213 CA Practitioner - Ophthalmology 9133206386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Yale University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11180 Warner Ave
Suite 151
Fountain Valley, CA 92708-7515
Phone (714) 444-0303

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G079014CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Choice Aco Inc CurrentSince Jan 1, 2022 Accepting new patients
Trung Minh Nguyen, MD, Inc Ophthalmology CurrentSince Feb 4, 2002 Accepting new patients
St Joseph Hospital of Orange PastSince Nov 14, 2010 Accepting new patients

Locations

11180 Warner Ave
Ste 151
Fountain Vly, CA 92708
Phone (714) 444-0303

7631 Wyoming St
Ste 201
Westminster, CA 92683
Phone (714) 898-0765

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1316941966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "address_2": "STE 151",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087515",
            "telephone_number": "714-444-0303",
            "fax_number": "714-444-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "address_2": "STE 151",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087515",
            "telephone_number": "714-444-0303",
            "fax_number": "714-444-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRUNG",
        "middle_name": "MINH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G079014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G790140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.