Ly Khanh Nguyen

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2344751 Issued in MA

Practice address

188 Quincy Ave Unit B2
Quincy, MA 02169-6774

Phone

(857) 381-9500

NPI assigned

Oct 1, 2024

Reactivated

Nov 1, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Revere Medical of Massachusetts PCGroup PAC ID 0749715795, 113 clinicians

Patriot Urgent Care Professionals PCGroup PAC ID 8820248784, 41 clinicians

Carecentral Urgent Care Medical Group PCGroup PAC ID 5496907099, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Medical Center Hospital, Brockton, MA, CCN 220111

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Carecentral Urgent Care Medical Group PC

  • Urgent Care Clinic/Center
  • Stoughton, MA
  • NPI 1922385319
  Medicare reassignment Care Compare group NPD
• Patriot Urgent Care Professionals, PC

  • Urgent Care Clinic/Center
  • Waltham, MA
  • NPI 1417205105
  Medicare reassignment Care Compare group NPD
• Revere Medical of Massachusetts, PC

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1336976539
  Medicare reassignment Care Compare group NPD
• Carecentral Urgent Care Medical Group PC

  • Urgent Care Clinic/Center
  • Halifax, MA
  • NPI 1053119677
  NPD
• Patriot Urgent Care Professionals PC

  • Urgent Care Clinic/Center
  • Cambridge, MA
  • NPI 1245123587
  NPD
• Patriot Urgent Care Professionals PC

  • Urgent Care Clinic/Center
  • Attleboro, MA
  • NPI 1356159172
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Boston Medical Center - South Corporation

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1871329110
  Care Compare affiliation

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1497573067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 CAMINO DEL RIO S STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083586",
            "telephone_number": "800-316-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 QUINCY AVE UNIT B2",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021696774",
            "telephone_number": "857-381-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LY",
        "middle_name": "KHANH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "deactivation_date": "2024-10-15",
        "reactivation_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MA",
            "license": "R2344751",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2344751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hieu Nguyen
• Hoang Thanh Hoa Nguyen, PHARMD
• Honghoa Nguyen, RN
• Hung Tien Nguyen, DMD
• Linda Nguyen
• Matthew Nguyen
• Phuong Thanh Nguyen, O.D.
• Quechi Nguyen
• Thanh Phuong Thi Nguyen, MA
• Thu Nguyen

• Family Nurse Practitioner in Quincy, MA
• Providers in Quincy, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.

Verify at the official NPI Registry.