Individual provider Active NPI

Chau Bao Nguyen, DO

  • Internal Medicine Physician
  • Georgetown, TX
National Provider Identifier
1396197661
Registry record updated Nov 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R9654 Issued in TX
Practice address
904 W University Ave Ste 101
Georgetown, TX 78626-6512
Phone
(512) 819-0264
Fax
(512) 406-6242
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R10587 IA
Internal Medicine Physician 207R00000X R9654 TX Primary

Addresses

Primary practice location

904 W University Ave Ste 101
Georgetown, TX 78626-6512

Mailing address

6210 E Hwy 290
Austin, TX 78723-1142
Phone (512) 483-9596

Other practice location 1

2301 Clear Creek Rd Ste 126
Killeen, TX 76549-4119
Phone (254) 519-3131

Other practice location 2

1111 6th Ave
Des Moines, IA 50314-2613
Phone (515) 643-2261

Other identifiers 3

IdentifierTypeStateIssuer
4001752MedicaidTX
4001752-02MedicaidTX
R9654OtherTXTEXAS MEDICAL LICENSE

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
I20190709001647 TX Practitioner - Internal Medicine 8921392937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

940 W University Ave
Suite 101
Georgetown, TX 78626-6503
Phone (737) 220-7500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R10587IAMDInternal Medicine Physician
R9654TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA Internal Medicine CurrentSince Sep 20, 2021 Accepting new patients
Austin Regional Clinic, PA CurrentSince Sep 20, 2021 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

6210 E Highway 290
Ste 240
Austin, TX 78723

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

6210 E Highway 290
Austin, TX 78723

1807 W Slaughter Ln
Ste 490
Austin, TX 78748
Phone (512) 282-8967

940 W University Ave
Ste 101
Georgetown, TX 78626
Phone (512) 819-0264

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

Interoperability endpoints

  • Direct secure messaging: cnguyen25927@arcmd.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.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636848000000",
    "number": "1396197661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HWY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142",
            "telephone_number": "512-483-9596",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W UNIVERSITY AVE STE 101",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266512",
            "telephone_number": "512-819-0264",
            "fax_number": "512-406-6242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Clear Creek Rd Ste 126",
            "address_purpose": "LOCATION",
            "city": "Killeen",
            "state": "TX",
            "postal_code": "765494119",
            "country_code": "US",
            "telephone_number": "254-519-3131",
            "fax_number": "254-519-3133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503142613",
            "country_code": "US",
            "telephone_number": "515-643-2261",
            "fax_number": "515-643-5802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CHAU",
        "middle_name": "BAO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2021-11-14",
        "certification_date": "2021-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "R10587",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R9654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4001752",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4001752-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL LICENSE",
            "identifier": "R9654",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.