Individual provider Active NPI

Ann L. Nguyen, MD.

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1356510747
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
235153 Issued in NY
Practice address
170 W 12TH St
Smith Building, 8TH Floor
New York, NY 10011-8202
Phone
(212) 604-8630
NPI assigned
Feb 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 235153 NY Primary

Addresses

Primary practice location

170 W 12TH St
Smith Building, 8TH Floor
New York, NY 10011-8202

Mailing address

170 W 12TH St
Smith Building, 8TH Floor
New York, NY 10011-8202
Phone (212) 604-8630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100922000023 NY Practitioner - Pediatric Medicine 6800912320 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235153NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Pediatrics CurrentSince Jan 14, 2019 Accepting new patients
Montefiore Medical Center CurrentSince Jan 14, 2019 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

600 E 233rd St
Fl 3
Bronx, NY 10466

600 E 233rd St
Bronx, NY 10466
Phone (718) 920-1640

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1356510747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 W 12TH ST",
            "address_2": "SMITH BUILDING, 8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118202",
            "telephone_number": "212-604-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 W 12TH ST",
            "address_2": "SMITH BUILDING, 8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118202",
            "telephone_number": "212-604-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANN",
        "middle_name": "L.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "235153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.