NPIMap

Individual provider Active NPI

Mary K Nguyen, M.D.

  • Family Medicine Physician
  • Parker, CO
National Provider Identifier
1386811362
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0065882 Issued in CO
Practice address
19964 Hilltop Rd Ste a
Parker, CO 80134-7316
Phone
(303) 841-2212
NPI assigned
May 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036122304 IL
Family Medicine Physician 207Q00000X DR.0065882 CO Primary

Addresses

Primary practice location

19964 Hilltop Rd Ste a
Parker, CO 80134-7316

Mailing address

1901 W Galena Blvd
Aurora, IL 60506-4305
Phone (630) 897-2848

Other practice location 1

4789 Route 71
Oswego, IL 60543-7415
Phone (630) 692-5730

Other practice location 2

1901 W Galena Blvd
Aurora, IL 60506-4305
Phone (630) 692-5960

Other names 1

  • Mary Nguyen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210803000177 CO Practitioner - Family Practice 6800057043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

19964 Hilltop Rd
Suite a
Parker, CO 80134-7316
Phone (303) 841-2212

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0065882COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Aug 16, 2021 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Aug 16, 2021 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

16990 Village Center Dr E
Parker, CO 80134
Phone (303) 805-3020

19964 Hilltop Rd
Ste A
Parker, CO 80134
Phone (303) 841-2212

Interoperability endpoints

  • Direct secure messaging: mnguyen84002@direct.rush.rush-health.com

Organizations & group practices 2

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 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1386811362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W GALENA BLVD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064305",
            "telephone_number": "630-897-2848",
            "fax_number": "630-897-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19964 HILLTOP RD STE A",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347316",
            "telephone_number": "303-841-2212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4789 Route 71",
            "address_purpose": "LOCATION",
            "city": "Oswego",
            "state": "IL",
            "postal_code": "605437415",
            "country_code": "US",
            "telephone_number": "630-692-5730",
            "fax_number": "630-692-5731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 W Galena Blvd",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605064305",
            "country_code": "US",
            "telephone_number": "630-692-5960",
            "fax_number": "630-692-5961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036122304",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0065882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "NGUYEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Parker, CO

Sources for this page

Verify at the official NPI Registry.