Active NPI
Andrew Nguyen, MD
- Pediatrics Physician
- New York, NY
National Provider Identifier
1356704647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 314077
- Practice address
- 462 1St Ave
New York, NY 10016-9196 - Phone
- (212) 562-5579
- NPI assigned
- Apr 4, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 32463 | OK | |
| Pediatrics Physician | 208000000X | 314077 | NY | Primary |
Addresses
Primary practice location
462 1St Ave
New York, NY 10016-9196
Mailing address
PO Box 268838
Oklahoma City, OK 73126-8838
Phone (918) 660-3632
Other practice location 1
4444 E 41st St
Tulsa, OK 74135-2527
Phone (918) 619-4400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06938678 | Medicaid | NY | |
| 200652800B | Medicaid | OK |
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: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 314077 | NY | MD | Pediatrics Physician |
| 32463 | OK | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Pediatrics | Current | Accepting new patients |
| New York City Health and Hospitals Corporation | Past | Accepting new patients |
Locations
500 1st Ave
New York, NY 10016
Phone (212) 562-4141
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
Interoperability endpoints
- anguyen2005876@nychhc.direct-ci.com
- anguyen572446@nyumc.direct-ci.com
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.
-
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY, Pediatrics
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- General Acute Care Hospital
- New York, NY
- NPI 1073535027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1356704647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 268838",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731268838",
"telephone_number": "918-660-3632",
"fax_number": "918-660-3631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "462 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100169196",
"telephone_number": "212-562-5579"
}
],
"practiceLocations": [
{
"address_1": "4444 E 41st St",
"address_purpose": "LOCATION",
"city": "Tulsa",
"state": "OK",
"postal_code": "741352527",
"country_code": "US",
"telephone_number": "918-619-4400",
"fax_number": "918-619-4334",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-04",
"last_updated": "2022-12-13",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OK",
"license": "32463",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "314077",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06938678",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200652800B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.