Individual provider Active NPI

Mykhanh Connie Nguyen, M.D.

  • Radiation Oncology Physician
  • Tulsa, OK
National Provider Identifier
1508820606
Registry record updated Apr 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
25678 Issued in OK
Practice address
12697 E 51St St
Tulsa, OK 74146-6236
Phone
(918) 505-3200
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 200001614 NC
Radiation Oncology Physician 2085R0001X 25678 OK Primary

Addresses

Primary practice location

12697 E 51St St
Tulsa, OK 74146-6236

Mailing address

12697 E 51St St
Tulsa, OK 74146-6236
Phone (918) 505-3200

Other identifiers 2

IdentifierTypeStateIssuer
200113090AMedicaidOK
89128EEMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20071026000603 OK Practitioner - Radiation Oncology 9739276411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of California, Geffen School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12697 E 51St St
Tulsa, OK 74146-6236
Phone (918) 505-3200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.92 of 100Reported as individual
Quality
83
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200001614NCMDRadiation Oncology Physician
25678OKMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Cancer Specialists and Research Institute LLC Current Accepting new patients
Oklahoma Cancer Specialists and Research Institute, LLC CurrentSince Feb 10, 2016 Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC Radiation Oncology CurrentSince Feb 10, 2016 Accepting new patients
Oklahoma Cancer Specialists and Research Institute LLC Radiation Oncology Past Accepting new patients

Locations

901 N Strong Blvd
McAlester, OK 74501
Phone (918) 426-0625

12697 E 51st St
Tulsa, OK 74146
Phone (918) 505-3200

Interoperability endpoints

  • Direct secure messaging: mykhanh.nguyen.p1@direct.smc.nextgenshare.com

Organizations & group practices 4

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 4

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397174400000",
    "number": "1508820606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12697 E 51ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741466236",
            "telephone_number": "918-505-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12697 E 51ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741466236",
            "telephone_number": "918-505-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MYKHANH",
        "middle_name": "CONNIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2014-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NC",
            "license": "200001614",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OK",
            "license": "25678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200113090A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89128EE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.