Individual provider Active NPI

Samantha Kieu Nguyen, PT, DPT

  • Physical Therapist
  • Seal Beach, CA
National Provider Identifier
1467161851
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
303227 Issued in CA
Practice address
12501 Seal Beach Blvd
Seal Beach, CA 90740-2763
Phone
(562) 493-8800
NPI assigned
Nov 15, 2022
Last updated
Nov 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 303227 CA Primary

Addresses

Primary practice location

12501 Seal Beach Blvd
Seal Beach, CA 90740-2763

Mailing address

6569 Tangier Way
Cypress, CA 90630-5420
Phone (714) 595-0584

Other practice location 1

3751 Katella Ave
Los Alamitos, CA 90720-3113
Phone (562) 598-1311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221201001878 CA Practitioner - Physical Therapist in Private Practice 7315315942 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1467161851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6569 TANGIER WAY",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906305420",
            "telephone_number": "714-595-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 SEAL BEACH BLVD",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402763",
            "telephone_number": "562-493-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3751 Katella Ave",
            "address_purpose": "LOCATION",
            "city": "Los Alamitos",
            "state": "CA",
            "postal_code": "907203113",
            "country_code": "US",
            "telephone_number": "562-598-1311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "SAMANTHA",
        "middle_name": "KIEU",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seal Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.