Individual provider Active NPI

Stephanie Nguyen, DO

  • Emergency Medicine Physician
  • Pleasanton, CA
National Provider Identifier
1427637792
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
22611 Issued in CA
Practice address
5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone
(925) 847-3000
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 22611 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000

Mailing address

1505 W Sherman Ave
Vineland, NJ 08360-7059
Phone (856) 641-8000

Other practice location 1

1505 W Sherman Ave
Vineland, NJ 08360-7059
Phone (856) 641-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240927000074 CA Practitioner - Emergency Medicine 4183155419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pleasanton Emergency Medical GroupGroup PAC ID 0143118927, 38 clinicians

Practice addresses (Care Compare)

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone (925) 416-3418

Hospital & facility affiliations

  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pleasanton Emergency Medical Group Emergency Medicine CurrentSince Aug 6, 2024 Accepting new patients

Locations

1133 E Stanley Blvd
Livermore, CA 94550
Phone (925) 373-4500

1111 E Stanley Blvd
Livermore, CA 94550
Phone (925) 373-4018

5555 W Las Positas Blvd
Pleasanton, CA 94588
Phone (925) 416-3418

Organizations & group practices 1

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 2

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1427637792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607059",
            "telephone_number": "856-641-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W LAS POSITAS BLVD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884000",
            "telephone_number": "925-847-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 W Sherman Ave",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083607059",
            "country_code": "US",
            "telephone_number": "856-641-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "STEPHANIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "22611",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.