Individual provider Active NPI

Phuong Nguyen, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1336505064
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP024773 Issued in PA
Practice address
1500 Market St
Philadelphia, PA 19102-2100
Phone
(215) 680-1491
NPI assigned
Jan 11, 2016
Last updated
May 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP015515 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X LG-0001256 DE
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP024773 PA Primary
Primary Care Nurse Practitioner 363LP2300X SP015515 PA
Primary Care Nurse Practitioner 363LP2300X SP024773 PA

Addresses

Primary practice location

1500 Market St
Philadelphia, PA 19102-2100

Mailing address

1500 Market St
LM-500 West Tower
Philadelphia, PA 19102-2100
Phone (215) 680-1491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20160426000185 PA Practitioner - Nurse Practitioner 3274832266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Co Mhar IncGroup PAC ID 1951398452, 22 clinicians

Practice addresses (Care Compare)

2055 E Allegheny Ave
Philadelphia, PA 19134-3832
Phone (215) 427-5800

2600 N American St
Philadelphia, PA 19133-3413
Phone (215) 739-2669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP024773PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comhar, Inc Current Accepting new patients
Comhar Inc CurrentSince Sep 4, 2024 Accepting new patients
Quality Community Health Care, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Excel Medical Center PastSince Sep 13, 2010 Accepting new patients

Locations

100 W Lehigh Ave
Philadelphia, PA 19133
Phone (215) 203-3000

2055 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 427-5800

2501 W Lehigh Ave
Philadelphia, PA 19132
Phone (215) 227-0300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25233/brand/1/csg/1/fhir/r4
  • Direct secure messaging: phuong.nguyen.1@25278.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1336505064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST",
            "address_2": "LM-500 WEST TOWER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022100",
            "telephone_number": "215-680-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022100",
            "telephone_number": "215-680-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUONG",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015515",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "LG-0001256",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP024773",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP015515",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP024773",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.