Individual provider Active NPI

Uyen Theresa Truong, MD

  • Pediatrics Physician
  • Saint Paul, MN
National Provider Identifier
1457914392
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
BP10066867 Issued in TX
Practice address
200 University Ave E
Saint Paul, MN 55101-2507
Phone
(651) 291-2848
NPI assigned
Apr 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP10066867 TX Primary

Addresses

Primary practice location

200 University Ave E
Saint Paul, MN 55101-2507

Mailing address

4900 Mueller Blvd Ste 3S.066C
Austin, TX 78723-3079

Other practice location 1

4900 Mueller Blvd Ste 3S.066C
Austin, TX 78723-3079
Phone (512) 324-0165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20230530000415 MN Practitioner - Pediatric Medicine 9436531258 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10066867TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Children's Specialty Healthcare CurrentSince Jun 30, 2023 Accepting new patients
Gillette Children's Specialty Healthcare CurrentSince Jun 30, 2023 Accepting new patients
Gillette Children's Specialty Healthcare Past Accepting new patients
Gillette Children's Specialty Healthcare PastSince Sep 23, 2021 Accepting new patients

Locations

200 University Ave E
#10614
Saint Paul, MN 55101

200 University Ave E
Saint Paul, MN 55101
Phone (651) 291-2848

435 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-3200

Organizations & group practices 4

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": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1457914392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD STE 3S.066C",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012507",
            "telephone_number": "651-291-2848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Mueller Blvd Ste 3S.066C",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787233079",
            "country_code": "US",
            "telephone_number": "512-324-0165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "UYEN",
        "middle_name": "THERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10066867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.