Individual provider Active NPI

Long H Nguyen, MD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1518249291
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MT223355 Issued in PA
Practice address
5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098
Phone
(215) 456-7890
NPI assigned
Sep 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03388400 NJ
Diagnostic Radiology Physician 2085R0202X MT223355 PA Primary

Addresses

Primary practice location

5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098

Mailing address

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-7890

Other practice location 1

4601 Westfield Ave
Pennsauken, NJ 08110-3029
Phone (856) 663-3405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28RI03388400NJMDPharmacist
MT223355PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1518249291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-456-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD STE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413098",
            "telephone_number": "215-456-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4601 Westfield Ave",
            "address_purpose": "LOCATION",
            "city": "Pennsauken",
            "state": "NJ",
            "postal_code": "081103029",
            "country_code": "US",
            "telephone_number": "856-663-3405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LONG",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-19",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03388400",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT223355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.