Individual provider Active NPI

Bao Anh Le Nguyen, M.D.

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1588673024
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A89126 Issued in CA
Practice address
1441 E Via Verde Dr
Fresno, CA 93730-8806
Phone
(559) 478-7017
Fax
(559) 433-0443
NPI assigned
Aug 5, 2006
Last updated
Jan 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A89126 CA Primary

Addresses

Primary practice location

1441 E Via Verde Dr
Fresno, CA 93730-8806

Mailing address

1441 E Via Verde Dr
Fresno, CA 93730-8806
Phone (559) 478-7017

Other identifiers 1

IdentifierTypeStateIssuer
00A891260MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

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
I20070131000244 CA Practitioner - Internal Medicine 2163423336 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A89126CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Internal Medicine Current Accepting new patients
Galen Inpatient Physicians PC CurrentSince Oct 1, 2012 Accepting new patients
Community Foundation Medical Group CurrentSince Jul 1, 2012 Accepting new patients
Permanente Medical Group, Inc CurrentSince Mar 24, 2013 Accepting new patients
Galen Inpatient Physicians, PC Current Accepting new patients
Fresno Community Hospital and Medical Center CurrentSince Apr 1, 2010 Accepting new patients
Fresno Community Hospital and Medical Center CurrentSince Apr 1, 2010 Accepting new patients
Community Foundation Medical Group Internal Medicine Current Accepting new patients
Permanente Medical Group Inc Internal Medicine CurrentSince Mar 24, 2013 Accepting new patients
Galen Inpatient Physicians PC Internal Medicine CurrentSince Oct 1, 2012 Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

7520 Arroyo Cir
Gilroy, CA 95020
Phone (408) 846-2351

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 10

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 1

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1588673024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 E VIA VERDE DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937308806",
            "telephone_number": "559-478-7017",
            "fax_number": "559-433-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 E VIA VERDE DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937308806",
            "telephone_number": "559-478-7017",
            "fax_number": "559-433-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "BAO",
        "middle_name": "ANH LE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A89126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A891260",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7520 Arroyo Cir",
            "city": "Gilroy",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950207303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.