Organization Active NPI

David Nguyen MD PS Inc

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1558464198
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00039167 Issued in WA
Legal business name
DAVID NGUYEN MD PS INC
Practice address
2120 Rainier Ave S
#C
Seattle, WA 98144
Phone
(206) 860-0288
Fax
(206) 328-0489
NPI assigned
Sep 7, 2006
Last updated
May 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Authorized official

Name
David D Nguyen, MDNPI 1700822103
Title
President
Phone
(206) 860-0288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00039167 WA Primary

Addresses

Primary practice location

2120 Rainier Ave S
#C
Seattle, WA 98144

Mailing address

2120 Rainier Ave S
#C
Seattle, WA 98144
Phone (206) 860-0288

Other identifiers 1

IdentifierTypeStateIssuer
1116490MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603001173 WA Part B Supplier - Clinic/Group Practice 0547242414 Receives reassigned benefits from 1 practitioner
Practice locations: Seattle, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D1005699Nguyen, David D, MD2120 Rainier Ave S #C, Seattle, WA 98144Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305244800000",
    "number": "1558464198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 RAINIER AVE S",
            "address_2": "#C",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98144",
            "telephone_number": "206-860-0288",
            "fax_number": "206-328-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 RAINIER AVE S",
            "address_2": "#C",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98144",
            "telephone_number": "206-860-0288",
            "fax_number": "206-328-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID NGUYEN MD PS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2011-05-13",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-860-0288",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00039167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1116490",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.