NPIMap

Individual provider Active NPI

Khoa Mai Nguyen, D.O.

  • Orthopaedic Surgery Physician
  • Mount Laurel, NJ
National Provider Identifier
1487948071
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
25MB100776200 Issued in NJ
Practice address
2059 Briggs Rd Ste 304
Mount Laurel, NJ 08054-4640
Phone
(856) 235-7080
Fax
(856) 273-6384
NPI assigned
Jun 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2016-00846 NC
Orthopaedic Surgery Physician 207X00000X 25MB100776200 NJ Primary

Addresses

Primary practice location

2059 Briggs Rd Ste 304
Mount Laurel, NJ 08054-4640

Mailing address

2059 Briggs Rd Ste 304
Mount Laurel, NJ 08054-4640
Phone (856) 235-7080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170628002951 NJ Practitioner - Orthopedic Surgery 6901193077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burlington County Orthopaedic Specialists PAGroup PAC ID 6103818976, 5 clinicians

Practice addresses (Care Compare)

2059 Briggs Rd
Suite 304
Mount Laurel, NJ 08054-4640
Phone (856) 235-7080

Hospital & facility affiliations

  • Virtua Home Care at West Jersey Home health agency, Marlton, NJ, CCN 317071
  • Bayada Home Health Care, Inc Home health agency, Pennsauken, NJ, CCN 317065
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Deborah Heart and Lung Center Hospital, Browns Mills, NJ, CCN 310031
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement31
Knee replacement62
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB100776200NJMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Burlington County Orthopaedic Specialists PA Orthopaedic Surgery CurrentSince Aug 1, 2017 Accepting new patients

Locations

2059 Briggs Rd
Ste 304
Mount Laurel, NJ 08054
Phone (609) 379-7000

Interoperability endpoints

  • Direct secure messaging: khoanguyen@bcospa.allscriptsdirect.net

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 10

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1487948071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2059 BRIGGS RD STE 304",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544640",
            "telephone_number": "856-235-7080",
            "fax_number": "856-273-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2059 BRIGGS RD STE 304",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544640",
            "telephone_number": "856-235-7080",
            "fax_number": "856-273-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KHOA",
        "middle_name": "MAI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2016-00846",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MB100776200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.