Individual provider Active NPI

Bach Tuyet Thi Le, PA-C

  • Physician Assistant
  • Gastonia, NC
National Provider Identifier
1417255746
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-02731 Issued in NC
Practice address
111 E 3Rd Ave
Gastonia, NC 28052-4317
Phone
(704) 874-3300
Fax
(704) 874-0065
NPI assigned
Mar 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-02731 NC Primary

Addresses

Primary practice location

111 E 3Rd Ave
Gastonia, NC 28052-4317

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110802000146 NC Practitioner - Physician Assistant 4486823846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gaston Family Health Services IncGroup PAC ID 5496733925, shared by 94 NPIs, 98 clinicians

Practice addresses (Care Compare)

991 W Hudson Blvd
Gastonia, NC 28052-6430
Phone (704) 853-5079

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1705SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Family Health Services, Inc CurrentSince Feb 28, 2022 Accepting new patients
Gaston Family Health Services, Inc. CurrentSince Feb 28, 2022 Accepting new patients

Locations

991 W Hudson Blvd
Gastonia, NC 28052
Phone (704) 853-5000

200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904

111 E 3rd Ave
Gastonia, NC 28052
Phone (704) 853-5079

Interoperability endpoints

  • Direct secure messaging: ble377460@direct.ochin.org

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1417255746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 3RD AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524317",
            "telephone_number": "704-874-3300",
            "fax_number": "704-874-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "BACH TUYET",
        "middle_name": "THI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-10",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.