Derrick John Nguyen, PT, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

300935 Issued in CA

Practice address

19768 Yorba Linda Blvd
Yorba Linda, CA 92886-2801

Phone

(714) 693-0460

NPI assigned

Nov 22, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovative Wellness Solutions IncGroup PAC ID 2961395462, 5 clinicians

Ignite Phyzio and Sports Performance IncGroup PAC ID 0042649584, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Innovative Wellness Solutions Inc

  dba California Rehabilitation and Sports Therapy

  • Physical Therapist
  • Yorba Linda, CA
  • NPI 1356367411
  Medicare reassignment Care Compare group NPD
• Ignite Phyzio & Sports Performance Inc

  • Physical Therapy Clinic/Center
  • La Habra, CA
  • NPI 1306354881
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1609533819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19768 YORBA LINDA BLVD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928862801",
            "telephone_number": "714-693-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19768 YORBA LINDA BLVD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928862801",
            "telephone_number": "714-693-0460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15000 Kensington Park Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927821831",
            "country_code": "US",
            "telephone_number": "657-859-6458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DERRICK",
        "middle_name": "JOHN",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Beginnings Christian Counseling Family Services, PC (New Beginnings Christian Counseling)
• New Paths Family Counseling
• Tanya Ngo
• Aileen Nguyen
• David Nguyen, OD
• Duyen T Nguyen
• Jacqueline Nguyen
• Johnny Nguyen, PT, DPT
• Kim Hong Nguyen, D.M.D
• Matthew Nguyen, DDS

• Physical Therapist in Yorba Linda, CA
• Providers in Yorba Linda, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.