Individual provider Active NPI

Jonathan Toan Nguyen, D.O.

  • Family Medicine Physician
  • Scranton, PA
National Provider Identifier
1609215631
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OT015467 Issued in PA
Practice address
501 Madison Ave
Scranton, PA 18510-2401
Phone
(570) 991-8563
NPI assigned
Jun 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT015467 PA Primary

Addresses

Primary practice location

501 Madison Ave
Scranton, PA 18510-2401

Mailing address

501 Madison Ave
Scranton, PA 18510-2401
Phone (503) 935-9249

Other names 1

  • Dr. Jonathan Toan Ngoc Nguyen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171130001010 OR Practitioner - Family Practice 3375846843 Reassigns benefits to 1 organization
I20180104001660 WA Practitioner - Family Practice 3375846843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

3500 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

3600 N Interstate Ave
Portland, OR 97227-1106
Phone (800) 813-2000

3620 N Interstate Ave
Portland, OR 97227-1106
Phone (800) 813-2000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Oct 23, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 23, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 23, 2017 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

12100 SE Stevens Ct
Ste 106
Portland, OR 97086
Phone (503) 331-6330

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1609215631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102401",
            "telephone_number": "503-935-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MADISON AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102401",
            "telephone_number": "570-991-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JONATHAN",
        "middle_name": "TOAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT015467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONATHAN",
            "last_name": "NGUYEN",
            "middle_name": "TOAN NGOC",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.