NPIMap

Individual provider Active NPI

Jacqueline Kim Nguyen, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Napa, CA
National Provider Identifier
1609111665
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
A128602 Issued in CA
Practice address
3273 Claremont Way Ste 100
Napa, CA 94558
Phone
(707) 254-7117
Fax
(707) 265-6435
NPI assigned
Dec 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 56195 TN
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X A128602 CA Primary

Addresses

Primary practice location

3273 Claremont Way Ste 100
Napa, CA 94558

Mailing address

3273 Claremont Way
Ste 100
Napa, CA 94558-3328
Phone (310) 702-2084

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180926002827 CA Practitioner - Orthopedic Surgery 9133489016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Georgetown University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

22 W 39TH Ave
San Mateo, CA 94403-4364

222 W 39TH Ave
San Mateo, CA 94403-4364

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56195TNMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince May 6, 2023 Accepting new patients
County of San Mateo CurrentSince May 6, 2023 Accepting new patients
County of San Mateo CurrentSince May 6, 2023 Accepting new patients
CC Bpci PLC Orthopaedic Surgery Past Accepting new patients

Locations

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Interoperability endpoints

  • Direct secure messaging: jnguyen@cco1043.srs-direct.com
  • Direct secure messaging: jnguyen19710@smch.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1609111665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3273 CLAREMONT WAY",
            "address_2": "STE 100",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583328",
            "telephone_number": "310-702-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3273 CLAREMONT WAY STE 100",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "94558",
            "telephone_number": "707-254-7117",
            "fax_number": "707-265-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JACQUELINE",
        "middle_name": "KIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "56195",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CA",
            "license": "A128602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.