Individual provider Active NPI

Phuc Kim Hoang Nguyen, D.O

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1497008148
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34.011832 Issued in OH
Practice address
5969 E Broad St
Columbus, OH 43213-1546
Phone
(614) 234-7090
NPI assigned
Oct 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34.011832 OH Primary

Addresses

Primary practice location

5969 E Broad St
Columbus, OH 43213-1546

Mailing address

5969 E Broad St
Columbus, OH 43213-1546
Phone (614) 234-7090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150820010638 OH Practitioner - Emergency Medicine 1153636063 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio University, College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knox Emergency Services LLC 9 clinicians

Practice addresses (Care Compare)

1330 Coshocton Ave
Mount Vernon, OH 43050-1440
Phone (740) 393-9000

Hospital & facility affiliations

  • Knox Community Hospital Hospital, Mount Vernon, OH, CCN 360040

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.011832OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Knox Emergency Services, LLC Emergency Medicine CurrentSince Jan 1, 2018 Accepting new patients
Cep America - Ohio LLC Emergency Medicine CurrentSince Dec 1, 2017 Accepting new patients
Ohio Emergency Care Services, Inc Emergency Medicine CurrentSince May 22, 2017 Accepting new patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Aug 1, 2015 Accepting new patients
Cep America - Ohio LLC Emergency Medicine CurrentSince Dec 1, 2017 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

7853 Pacer Dr
Delaware, OH 43015
Phone (614) 355-7900

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

651 W Marion Rd
Mount Gilead, OH 43338
Phone (419) 946-5015

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

500 S Cleveland Ave
Westerville, OH 43081
Phone (380) 898-4000

Organizations & group practices 5

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 1

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": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1497008148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5969 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131546",
            "telephone_number": "614-234-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5969 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131546",
            "telephone_number": "614-234-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUC",
        "middle_name": "KIM HOANG",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.011832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.