Individual provider Active NPI

Thanh Danae Vu, MD

  • Obstetrics & Gynecology Physician
  • Lapwai, ID
National Provider Identifier
1366447237
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
M-12786 Issued in ID
Practice address
111 Bever Grade Road
Lapwai, ID 83540-0367
Phone
(208) 843-2271
Fax
(208) 621-4995
NPI assigned
Jun 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD00040493 WA
Obstetrics & Gynecology Physician 207V00000X M-12786 ID Primary

Addresses

Primary practice location

111 Bever Grade Road
Lapwai, ID 83540-0367

Mailing address

PO Box 367
Lapwai, ID 83540-0367
Phone (208) 843-2271

Other identifiers 1

IdentifierTypeStateIssuer
8381873MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140417001197 TX Practitioner - Obstetrics/Gynecology 6103819685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York Medical College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nez Perce Tribal Health Authority 16 clinicians

Practice addresses (Care Compare)

111 Bever Grade Rd
Nimiipuu Health
Lapwai, ID 83540-0367
Phone (208) 621-4946

Hospital & facility affiliations

  • St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-12786IDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nez Perce Tribal Health Authority CurrentSince Mar 5, 2014 Accepting new patients

Locations

313 3Rd St
Nimiipuu Health
Kamiah, ID 83536
Phone (208) 621-4946

Interoperability endpoints

  • Direct secure messaging: danaev@nimiipuuhealth.directbygreenway.com

Organizations & group practices 1

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 2

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1366447237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "LAPWAI",
            "state": "ID",
            "postal_code": "835400367",
            "telephone_number": "208-843-2271",
            "fax_number": "208-621-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BEVER GRADE ROAD",
            "city": "LAPWAI",
            "state": "ID",
            "postal_code": "835400367",
            "telephone_number": "208-843-2271",
            "fax_number": "208-621-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "THANH DANAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00040493",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M-12786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8381873",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapwai, ID

Sources for this page

Verify at the official NPI Registry.