Individual provider Active NPI

Kenneth Van Nguyen, CRNA

  • Certified Registered Nurse Anesthetist
  • Fresno, CA
National Provider Identifier
1497272835
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA95000772 Issued in CA
Practice address
2823 Fresno St
Fresno, CA 93721-1324
Phone
(559) 451-1602
NPI assigned
Aug 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA95000772 CA Primary
Certified Registered Nurse Anesthetist 367500000X 95000772 CA

Addresses

Primary practice location

2823 Fresno St
Fresno, CA 93721-1324

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180618000877 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921353897 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health PartnersGroup PAC ID 6608280268, 497 clinicians

Practice addresses (Care Compare)

15 E Audubon Dr
Fresno, CA 93720-1542
Phone (559) 433-8000

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

45 E River Park PL W
Fresno, CA 93720-1565
Phone (559) 320-0530

805 W Acequia Ave
Suite 2D
Visalia, CA 93291-6164
Phone (559) 320-0530

Hospital & facility affiliations

  • Community Regional Medical Center Hospital, Fresno, CA, CCN 050060

Merit-based Incentive Payment System (MIPS)

Final score
92.04 of 100Reported as group
Quality
78.62
Promoting interoperability
100
Improvement activities
40
Cost
75.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
95000772CAMDCertified Registered Nurse Anesthetist
NA95000772CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partners CurrentSince Aug 14, 2021 Accepting new patients
Community Foundation Medical Group CurrentSince Jun 1, 2018 Accepting new patients
Community Foundation Medical Group CurrentSince Jun 1, 2018 Accepting new patients

Locations

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

7257 N Fresno St
Fresno, CA 93720
Phone (559) 447-4050

7417 N Cedar Ave
Ste 101
Fresno, CA 93720
Phone (559) 437-5645

1843 E Fir Ave
Ste 104
Fresno, CA 93720
Phone (559) 323-6611

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

7417 N Cedar Ave
Fresno, CA 93720
Phone 5594360871111

15 E Audubon Dr
Fresno, CA 93720
Phone (559) 433-8000

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

Organizations & group practices 3

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": "1503705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1497272835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-451-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KENNETH",
        "middle_name": "VAN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-26",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95000772",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000772",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.