Organization Active NPI

Ngoc-Ha Thi Nguyen MD PC

  • Internal Medicine Physician
  • Annandale, VA
National Provider Identifier
1396795605
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101053981 Issued in VA
Legal business name
NGOC-HA THI NGUYEN MD PC
Practice address
7202C Poplar St
Annandale, VA 22003
Phone
(703) 642-3220
Fax
(703) 778-9863
NPI assigned
May 10, 2006
Last updated
Mar 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Authorized official

Name
Dr. Ngoc Ha Thi Nguyen, MDNPI 1750346870
Title
President
Phone
(703) 642-3220

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 0101053981 VA Primary

Addresses

Primary practice location

7202C Poplar St
Annandale, VA 22003

Mailing address

PO Box 1645
Annandaue, VA 22003
Phone (703) 642-3220

Other identifiers 2

IdentifierTypeStateIssuer
490895OtherVAMEDICARE PTAN
5852340MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080701000099 DC Part B Supplier - Clinic/Group Practice 6608948054 Receives reassigned benefits from 1 practitioner
Practice locations: Annandale, VA

National Provider Directory

National Provider Directory

Locations

7202 Poplar St
Ste C
Annandale, VA 22003
Phone (703) 642-3220

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1396795605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1645",
            "city": "ANNANDAUE",
            "state": "VA",
            "postal_code": "22003",
            "telephone_number": "703-642-3220",
            "fax_number": "703-778-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7202C POPLAR ST",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "22003",
            "telephone_number": "703-642-3220",
            "fax_number": "703-778-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGOC-HA THI NGUYEN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "NGOC HA",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-642-3220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101053981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "490895",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5852340",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.