Active NPI
Khuong Nguyen
- Surgery Physician
- Philadelphia, PA
National Provider Identifier
1417691619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MT229380
- Practice address
- 5501 Old York Rd Ste 101
Philadelphia, PA 19141-3018 - Phone
- (215) 457-4444
- NPI assigned
- Apr 24, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MT229380 | PA | Primary |
Addresses
Primary practice location
5501 Old York Rd Ste 101
Philadelphia, PA 19141-3018
Mailing address
1623 Strand St Apt 305
Galveston, TX 77550-2489
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT229380 | PA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706659200000",
"number": "1417691619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1623 STRAND ST APT 305",
"city": "GALVESTON",
"state": "TX",
"postal_code": "775502489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5501 OLD YORK RD STE 101",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191413018",
"telephone_number": "215-457-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KHUONG",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-24",
"last_updated": "2024-01-31",
"certification_date": "2024-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MT229380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.