Individual provider Active NPI

Brian Huu Tai Nguyen, PA-C

  • Physician Assistant
  • Renton, WA
National Provider Identifier
1609394188
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61071666 Issued in WA
Practice address
911 N 10TH PL
Renton, WA 98057-0009
Phone
(425) 391-5700
Fax
(425) 391-5701
NPI assigned
Sep 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61071666 WA Primary

Addresses

Primary practice location

911 N 10TH PL
Renton, WA 98057-0009

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
022444100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210122000210 WA Practitioner - Physician Assistant 4789940404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2450 33Rd Ave W
Suite 100
Seattle, WA 98199-3252
Phone (206) 320-3364

2600 Compass Rd
Glenview, IL 60026-8001

911 N 10TH PL
Renton, WA 98057-0009
Phone (425) 391-5700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61071666WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Oct 23, 2017 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Oct 23, 2017 Accepting new patients
Swedish Health Services CurrentSince Feb 1, 2021 Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

1600 SW Archer Rd
#100371
Gainesville, FL 32610
Phone (352) 265-8335

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

911 N 10th Pl
Renton, WA 98057
Phone (425) 391-5700

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 600
Seattle, WA 98104

Organizations & group practices 5

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 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": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1609394188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N 10TH PL",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980570009",
            "telephone_number": "425-391-5700",
            "fax_number": "425-391-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "BRIAN",
        "middle_name": "HUU TAI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-05",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61071666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022444100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.