Organization Active NPI

Stanislaus Kidney and Hypertension

  • Nephrology Physician
  • Merced, CA
National Provider Identifier
1366767899
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
STANISLAUS KIDNEY AND HYPERTENSION
Practice address
3393 G St
Suite D
Merced, CA 95340-0964
Phone
(209) 230-9065
NPI assigned
Mar 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Authorized official

Name
Dr. Thanh D. Nguyen, M.D.NPI 1346419918
Title
Ceo
Phone
(209) 230-9065

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

3393 G St
Suite D
Merced, CA 95340-0964

Mailing address

3393 G St
Suite D
Merced, CA 95340-0964
Phone (209) 620-7389

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101005000527 CA Part B Supplier - Clinic/Group Practice 4486846763 Receives reassigned benefits from 2 practitioners
Practice locations: Merced, CA; Turlock, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2010313Stanislaus Kidney & Hypertension3393 G St Ste D, Merced, CA 95340Certificate of waiverJul 22, 2028

National Provider Directory

National Provider Directory

Locations

3150 G St
#D
Merced, CA 95340
Phone (209) 230-9065

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1366767899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3393 G ST",
            "address_2": "SUITE D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400964",
            "telephone_number": "209-620-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3393 G ST",
            "address_2": "SUITE D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400964",
            "telephone_number": "209-230-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANISLAUS KIDNEY AND HYPERTENSION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-27",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "THANH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-230-9065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.