Individual provider Active NPI

Tien Quang Nguyen, MD

  • Dermatology Physician
  • Fountain Valley, CA
National Provider Identifier
1396741351
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G50454 Issued in CA
Practice address
17271 Brookhurst St
Fountain Valley, CA 92708-3701
Phone
(714) 531-2966
Fax
(714) 531-3495
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 20979 NV
Dermatology Physician 207N00000X G50454 CA Primary

Addresses

Primary practice location

17271 Brookhurst St
Fountain Valley, CA 92708-3701

Mailing address

17271 Brookhurst St
Fountain Valley, CA 92708-3701
Phone (714) 531-2966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060914000663 CA Practitioner - Dermatology 1850395344 Reassigns benefits to 1 organization
I20250217002432 NV Practitioner - Dermatology 1850395344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Florida College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tien Q Nguyen IncGroup PAC ID 0547319402, 12 clinicians
Tien Q Nguyen MD Dermatology Prof CorpGroup PAC ID 1254851553, 2 clinicians

Practice addresses (Care Compare)

17271 Brookhurst St
Fountain Valley, CA 92708-3701
Phone (714) 531-2966

17305 Von Karman Ave
Suite 107
Irvine, CA 92614-0903
Phone (949) 679-9997

3037 W Horizon Ridge Pkwy
Suite 120
Henderson, NV 89052-4191
Phone (702) 749-3303

4013 Reyes Ave
Las Vegas, NV 89141-8830

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision20
Removal of skin lesions1948
Removal of skin cancer1-10
Removal or shaving of skin growth1-10
Skin biopsy245

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G50454CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tien Q Nguyen MD Dermatology Prof Corp Dermatology CurrentSince Jan 4, 2025 Accepting new patients
First Oc Dermatology PC Dermatology CurrentSince Nov 17, 2008 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients

Locations

17271 Brookhurst St
Ste A
Fountain Valley, CA 92708
Phone (714) 531-2966

17271 Brookhurst St
Ste 417
Fountain Vly, CA 92708

17271 Brookhurst St
Fountain Vly, CA 92708
Phone (714) 531-2966

14281 Brookhurst St
Ste C
Garden Grove, CA 92843
Phone (714) 531-2966

17305 Von Karman Ave
Ste 107
Irvine, CA 92614
Phone (949) 478-2230

3037 W Horizon Ridge Pkwy
Ste 120
Henderson, NV 89052
Phone (702) 263-4993

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1396741351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17271 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083701",
            "telephone_number": "714-531-2966",
            "fax_number": "714-531-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17271 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083701",
            "telephone_number": "714-531-2966",
            "fax_number": "714-531-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TIEN",
        "middle_name": "QUANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "20979",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G50454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.