Active NPI
Nam-Phuong Nguyen, MD
- Pediatrics Physician
- Orlando, FL
National Provider Identifier
1508014861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME102535
- Practice address
- 1651 N Semoran Blvd
Orlando, FL 32807 - Phone
- (407) 249-1234
- Fax
- (407) 249-1755
- NPI assigned
- Aug 28, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME102535 | FL | Primary |
Addresses
Primary practice location
1651 N Semoran Blvd
Orlando, FL 32807
Mailing address
10140 Centurion Pkwy N
Jacksonville, FL 32256-0532
Phone (407) 249-1234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000411900 | Medicaid | FL |
Other names 1
- Phuong Ngoc Nguyen
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20180501002397 | FL | Order and Referring Only - Pediatric Medicine | 4082771035 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Health Alliance, LLC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- pnguyen70688@direct.nemours.org
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.
-
- Pediatrics Physician
- Orlando, FL
- NPI 1366709321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1508014861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10140 CENTURION PKWY N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322560532",
"telephone_number": "407-249-1234",
"fax_number": "407-249-1755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1651 N SEMORAN BLVD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "32807",
"telephone_number": "407-249-1234",
"fax_number": "407-249-1755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "NAM-PHUONG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-28",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME102535",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000411900",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PHUONG",
"last_name": "NGUYEN",
"middle_name": "NGOC",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.