Active NPI
Khoa Trong Nguyen, M.D.
- Specialist
- Shenandoah, TX
National Provider Identifier
1477551059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- K1885
- Practice address
- 920 Medical Plaza Dr
Suite 380
Shenandoah, TX 77380-3260 - Phone
- (281) 895-8555
- Fax
- (281) 895-8988
- NPI assigned
- Jul 8, 2005
- Reactivated
- Mar 27, 2006
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | K1885 | TX | Primary |
Addresses
Primary practice location
920 Medical Plaza Dr
Suite 380
Shenandoah, TX 77380-3260
Mailing address
920 Medical Plaza Dr
Suite 380
Shenandoah, TX 77380-3260
Phone (281) 895-8555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030273901 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040630000688 | TX | Practitioner - General Surgery | 3870570617 | Practice locations: The Woodlands, TX |
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Texas Medical School at San Antonio, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
920 Medical Plaza Dr
Suite 480
Shenandoah, TX 77380-3259
Phone (281) 895-8555
Hospital & facility affiliations
- Memorial Hermann Hospital System
- St Luke'S the Woodlands Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Removal of tissue | 17 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K1885 | TX | MD | Specialist |
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
-
- General Acute Care Hospital
- The Woodlands, TX
- NPI 1942208616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1477551059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 MEDICAL PLAZA DR",
"address_2": "SUITE 380",
"city": "SHENANDOAH",
"state": "TX",
"postal_code": "773803260",
"telephone_number": "281-895-8555",
"fax_number": "281-895-8988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 MEDICAL PLAZA DR",
"address_2": "SUITE 380",
"city": "SHENANDOAH",
"state": "TX",
"postal_code": "773803260",
"telephone_number": "281-895-8555",
"fax_number": "281-895-8988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KHOA",
"middle_name": "TRONG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-08",
"last_updated": "2010-02-24",
"deactivation_date": "2006-03-21",
"reactivation_date": "2006-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "K1885",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "030273901",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shenandoah, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.