NPIMap

Individual provider Active NPI

Charles Nguyen, M.D.

  • Nephrology Physician
  • Eastvale, CA
National Provider Identifier
1538400288
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A124779 Issued in CA
Practice address
12523 Limonite Ave Ste 400
Eastvale, CA 91752-3666
Phone
(951) 398-6868
Fax
(951) 221-8501
NPI assigned
Mar 5, 2013
Last updated
Aug 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A124779 CA
Nephrology Physician 207RN0300X A124779 CA Primary

Addresses

Primary practice location

12523 Limonite Ave Ste 400
Eastvale, CA 91752-3666

Mailing address

3660 Park Sierra Dr Ste 203
Riverside, CA 92505-3071
Phone (951) 687-3400

Other practice location 1

1901 Town and Country Dr
Norco, CA 92860-3611
Phone (951) 736-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140211000912 CA Practitioner - Internal Medicine 8022247220 Reassigns benefits to 1 organization
I20160712000886 CA Practitioner - NephrologyPractitioner - Internal Medicine 8022247220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates Medical Group IncGroup PAC ID 5092604447, 64 clinicians

Practice addresses (Care Compare)

1901 Town and Country Dr
Suite 102
Norco, CA 92860-3611
Phone (951) 736-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124779CAMDMarriage & Family Therapist
A124779CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates Medical Group Inc Nephrology CurrentSince Jul 18, 2016 Accepting new patients
Pih Health Physicians CurrentSince Apr 10, 2016 Accepting new patients
Pih Health Physicians Internal Medicine CurrentSince Apr 10, 2016 Accepting new patients
Pih Health Physicians Current Accepting new patients
Nephrology Associates Medical Group, Inc. PastSince Aug 15, 2021 Accepting new patients

Locations

2057 Compton Ave
Ste 102
Corona, CA 92881
Phone (951) 736-6757

12442 Limonite Ave
Unit 205
Eastvale, CA 91752
Phone (909) 429-2864

12523 Limonite Ave
Ste 400
Eastvale, CA 91752
Phone (951) 398-6868

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

1901 Town and Country Dr
Ste 102
Norco, CA 92860
Phone (951) 736-8100

3660 Park Sierra Dr
Ste 203
Riverside, CA 92505
Phone (951) 687-3400

3660 Park Sierra Dr
Ste 208
Riverside, CA 92505
Phone (951) 687-2800

15725 Whittier Blvd
Ste 400
Whittier, CA 90603
Phone (562) 947-1669

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: charles.nguyen.1@19859.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ampm Hospice IncSherman Oaks, CA, CCN B21712 Hospice 5% Or Greater Direct Ownership Interest (4%)
Corporate Director (4%)		 May 1, 2023
May 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Ampm Hospice, Inc.
    • Community Based Hospice Care Agency
    • Sherman Oaks, CA
    • NPI 1700403086

    5% Or Greater Direct Ownership Interest, Corporate Director

    CMS ownership

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1538400288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 PARK SIERRA DR STE 203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053071",
            "telephone_number": "951-687-3400",
            "fax_number": "951-687-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12523 LIMONITE AVE STE 400",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "917523666",
            "telephone_number": "951-398-6868",
            "fax_number": "951-221-8501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Town and Country Dr",
            "address_purpose": "LOCATION",
            "city": "Norco",
            "state": "CA",
            "postal_code": "928603611",
            "country_code": "US",
            "telephone_number": "951-736-8100",
            "fax_number": "951-736-8787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-05",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A124779",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A124779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastvale, CA

Sources for this page

Verify at the official NPI Registry.