Individual provider Active NPI

Amy Phuong Nguyen, MD

  • Anesthesiology Physician
  • Sylmar, CA
National Provider Identifier
1548792260
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A160294 Issued in CA
Practice address
14445 Olive View Drive
Department of Anesthesiology 3a-108
Sylmar, CA 91342
Phone
(747) 210-4350
NPI assigned
Mar 31, 2017
Last updated
Jul 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A160294 CA Primary

Addresses

Primary practice location

14445 Olive View Drive
Department of Anesthesiology 3a-108
Sylmar, CA 91342

Mailing address

14445 Olive View Drive
Department of Anesthesiology 3a-108
Sylmar, CA 91342
Phone (747) 210-4350

Other practice location 1

757 Westwood Plz
Anesthesiology
Los Angeles, CA 90095-7419
Phone (310) 267-8654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210517002473 CA Practitioner - Anesthesiology 6305255654 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, Geffen School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newport Harbor Anesthesia Consultants Medical Group IncGroup PAC ID 1759284771, 86 clinicians

Practice addresses (Care Compare)

1 Hoag Dr
Newport Beach, CA 92663-4162
Phone (949) 645-8600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A160294CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Auditor Controller CurrentSince Apr 29, 2021 Accepting new patients
Newport Harbor Anesthesia Consultants Medical Group Inc Anesthesiology CurrentSince Apr 18, 2022 Accepting new patients
County of Los Angeles CurrentSince Apr 29, 2021 Accepting new patients
County of Los Angeles Current Accepting new patients

Locations

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

14445 Olive View Dr
#3A108
Sylmar, CA 91342
Phone (747) 210-4350

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1548792260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DRIVE",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY 3A-108",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "747-210-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DRIVE",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY 3A-108",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "747-210-4350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Westwood Plz",
            "address_2": "Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900957419",
            "country_code": "US",
            "telephone_number": "310-267-8654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "AMY",
        "middle_name": "PHUONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A160294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

Verify at the official NPI Registry.