Michael CHI Dong Vuong, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110007759 Issued in VA

Practice address

882 Garrisonville Rd
Stafford, VA 22554-3907

Phone

(540) 318-6464

NPI assigned

Mar 14, 2021

Last updated

Mar 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

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 2

Specialty

Physician Assistant

Education

Florida State University College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians

Reston Radiology Consultants, PCGroup PAC ID 1557436730, 35 clinicians

Fair Oaks Imaging Center PCGroup PAC ID 7113918426, 17 clinicians

Optimum Care LLCGroup PAC ID 4082870241, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reston Hospital Center Hospital, Reston, VA, CCN 490107
• Stonesprings Hospital Center Hospital, Dulles, VA, CCN 490145

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Loudoun Medical Group, PC

  • Internal Medicine Physician
  • Leesburg, VA
  • NPI 1679591440
  Medicare reassignment Care Compare group NPD
• Optimum Care LLC

  • Emergency Medicine Physician
  • Stafford, VA
  • NPI 1093075798
  Medicare reassignment Care Compare group NPD
• Fair Oaks Imaging Center, PC

  • Diagnostic Radiology Physician
  • Fairfax, VA
  • NPI 1063437903

  DC

  Medicare reassignment Care Compare group
• Reston Radiology Consultants, PC

  • Diagnostic Radiology Physician
  • Reston, VA
  • NPI 1235307034

  DC

  Medicare reassignment Care Compare group
• Loudoun Imaging Center/Ashburn, LLC

  • Radiology Clinic/Center
  • Ashburn, VA
  • NPI 1568615094
  Medicare reassignment
• MRI of Reston, LP

  • Diagnostic Radiology Physician
  • Reston, VA
  • NPI 1164447025

  DC

  Medicare reassignment
• Pet of Reston, LP

  • Diagnostic Radiology Physician
  • Reston, VA
  • NPI 1922024041

  DC

  Medicare reassignment
• Loudoun Medical Group, PC

  dba Loudoun Medical Group, PC 'D'

  • Vascular Surgery Physician
  • Reston, VA
  • NPI 1588376321
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northern Virginia Community Hospital LLC

  dba StoneSprings Hospital Center

  • General Acute Care Hospital
  • Dulles, VA
  • NPI 1972904738
  Care Compare affiliation
• Reston Hospital Center LLC

  dba Reston Hospital Center

  • General Acute Care Hospital
  • Reston, VA
  • NPI 1053363853
  Care Compare affiliation

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1386229060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3907 FAIRFAX PKWY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121147",
            "telephone_number": "703-798-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 GARRISONVILLE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225543907",
            "telephone_number": "540-318-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19500 Sandridge Way, Suite 460",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201763694",
            "country_code": "US",
            "telephone_number": "571-206-0767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19500 Sandridge Way, Suite 420",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201763697",
            "country_code": "US",
            "telephone_number": "571-375-8601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3907 Fairfax Pkwy",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223121147",
            "country_code": "US",
            "telephone_number": "703-798-4109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VUONG",
        "first_name": "MICHAEL",
        "middle_name": "CHI DONG",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-14",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110007759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017745910001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386229060",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017745910002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia CVS Pharmacy LLC (CVS Pharmacy # 03396)
• Virginia CVS Pharmacy, L.L.C. (CVS Pharmacy # 02129)
• Virginia CVS Pharmacy, L.L.C. (CVS Pharmacy #01423)
• Virginia Footcare Center, LLC
• Vivacitypsych Inc.
• Kristy A Wade, DNP,APRN,PMHNP
• Barbara Evon Wadsworth, O.D.
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2438)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-6936)
• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)

• Physician Assistant in Stafford, VA
• Providers in Stafford, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.
• 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.