Individual provider Active NPI

Tri V Nguyen, MD

  • Dermatology Physician
  • Burlington, WI
National Provider Identifier
1417064866
Registry record updated Nov 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35961 Issued in WI
Doing business as
Tri Van Nguyen
Practice address
248 McHenry St
Burlington, WI 53105
Phone
(262) 767-8267
Fax
(262) 767-8212
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35961 WI Primary

Addresses

Primary practice location

248 McHenry St
Burlington, WI 53105

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 1

IdentifierTypeStateIssuer
32076700MedicaidWI

Other names 1

  • Tri Van Nguyen Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address tnguyen63904@direct.myadvocateaurora.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100505001043 WI Practitioner - Dermatology 4082742416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

248 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-8000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision25
Removal of skin lesions954
Removal of skin cancer379
Removal or shaving of skin growth389
Skin biopsy71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35961WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jun 1, 1997 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 1, 1997 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

248 McHenry St
Burlington, WI 53105
Phone (262) 767-8000

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

620 15th Ave
Union Grove, WI 53182
Phone (262) 878-1211

Interoperability endpoints

  • Direct secure messaging: tnguyen63904@direct.myadvocateaurora.org

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731801600000",
    "number": "1417064866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "53105",
            "telephone_number": "262-767-8267",
            "fax_number": "262-767-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRI",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2024-11-17",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "35961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32076700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "248 McHenry St",
            "city": "Burlington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tnguyen63904@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "248 McHenry St",
            "city": "Burlington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRI",
            "last_name": "NGUYEN",
            "middle_name": "VAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, WI

Sources for this page

Verify at the official NPI Registry.