Individual provider Active NPI

Van Nguyen, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1609508597
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA063674 Issued in PA
Practice address
1420 Locust St
Philadelphia, PA 19102-4223
Phone
(215) 800-1909
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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 MA063674 PA Primary

Addresses

Primary practice location

1420 Locust St
Philadelphia, PA 19102-4223

Mailing address

6803 Oakley St
Philadelphia, PA 19111-3914
Phone (267) 265-9443

Other practice location 1

1501 N Broad St
Philadelphia, PA 19122-3319
Phone (267) 457-5553

Other practice location 2

1008 Arch St
Philadelphia, PA 19107-3002
Phone (267) 881-9111

Other practice location 3

3717 Chestnut St
Philadelphia, PA 19104-3164
Phone (215) 921-8294

Other names 1

  • Vivienne Nguyen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220815001963 PA Practitioner - Physician Assistant 6901289503 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MHP MD PLLCGroup PAC ID 6507258423, 45 clinicians

Practice addresses (Care Compare)

10 E Ridge Pike
Conshohocken, PA 19428-2117

180 W Girard Ave
Suite 108
Philadelphia, PA 19123-1660
Phone (267) 319-8047

2329 Cottman Ave
Philadelphia, PA 19149-1003
Phone (267) 814-2401

3680 Aramingo Ave
Philadelphia, PA 19134-4608
Phone (267) 771-3680

48 A E Ridge Pike
Conshohocken, PA 19428-2117
Phone (484) 243-6735

9998 Frankford Ave
Philadelphia, PA 19114-1928
Phone (267) 669-1101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA063674PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Group, PC CurrentSince Aug 1, 2022 Accepting new patients

Locations

858 E Welsh Rd
Ste 10
Maple Glen, PA 19002
Phone (215) 283-2838

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1609508597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6803 OAKLEY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113914",
            "telephone_number": "267-265-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024223",
            "telephone_number": "215-800-1909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191223319",
            "country_code": "US",
            "telephone_number": "267-457-5553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1008 Arch St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191073002",
            "country_code": "US",
            "telephone_number": "267-881-9111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3717 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191043164",
            "country_code": "US",
            "telephone_number": "215-921-8294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIVIENNE",
            "last_name": "NGUYEN",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.