Active NPI
Diane Nguyen, PA-C
- Physician Assistant
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13595780-1206
- Practice address
- 1055 N 500 W
Ste 212 BLDG C
Provo, UT 84604 - Phone
- (801) 374-2362
- Fax
- (801) 429-8050
- NPI assigned
- Mar 3, 2022
- Last updated
- Feb 4, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13595780-1206 | UT | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1055 N 500 W
Ste 212 BLDG C
Provo, UT 84604
Mailing address
1055 N 500 W
Attn Credentialing
Provo, UT 84604
Phone (801) 354-8225
Other practice location 1
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (909) 362-9512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Utah School of Medicine, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1055 N 500
Provo, UT 84604-3305
Phone (801) 374-2362
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.77 of 100
- Quality
- 91.47
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| Revere Health PC | Current | Accepting new patients | |
| Utah Regional Hospitalists LLC | Current | Accepting new patients |
Locations
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
1055 N 500 W
Bldg C
Provo, UT 84604
Phone (801) 812-4624
1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 562-4210
Interoperability endpoints
- dianenguyen@cuccu.allscriptsdirect.net
Organizations & group practices 6
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.
-
- Hospitalist Physician
- Murray, UT
- NPI 1962821223
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
dba University of Utah Hospital Endocrinology Division
- Endocrinology, Diabetes & Metabolism Physician
- Salt Lake City, UT
- NPI 1588068381
-
dba University of Utah Hospital Radiology Department
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738627200000",
"number": "1568119154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"address_2": "ATTN CREDENTIALING",
"city": "PROVO",
"state": "UT",
"postal_code": "84604",
"telephone_number": "801-354-8225",
"fax_number": "801-418-0941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"address_2": "STE 212 BLDG C",
"city": "PROVO",
"state": "UT",
"postal_code": "84604",
"telephone_number": "801-374-2362",
"fax_number": "801-429-8050"
}
],
"practiceLocations": [
{
"address_1": "50 N Medical Dr",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841320001",
"country_code": "US",
"telephone_number": "909-362-9512",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "DIANE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-03",
"last_updated": "2025-02-04",
"certification_date": "2025-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "13595780-1206",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.