Individual provider Active NPI

Peterson Nguyen, PMHNP-BC, CRNA

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1619479797
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R217862 Issued in MD
Practice address
22 S Greene St FL 11
Baltimore, MD 21201-1544
Phone
(667) 214-1616
NPI assigned
Mar 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R217862 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R217862 MD Primary
Adult Health Nurse Practitioner 363LA2200X R217862 MD

Addresses

Primary practice location

22 S Greene St FL 11
Baltimore, MD 21201-1544

Mailing address

22 S Greene St FL 11
Baltimore, MD 21201-1544
Phone (667) 214-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180713002649 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557618048 Reassigns benefits to 1 organization
I20180910000351 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557618048 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifebridge Anesthesia Associates LLCGroup PAC ID 2062514888, 109 clinicians

Practice addresses (Care Compare)

2200 Kernan Dr
Baltimore, MD 21207-6665
Phone (410) 328-6720

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone 80051653155104

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group Anesthesiology LLC CurrentSince Nov 15, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 9, 2018 Accepting new patients
North American Partners in Anesthesia Maryland LLC CurrentSince Jul 21, 2018 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Nov 15, 2022 Accepting new patients
Lifebridge Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2023 Accepting new patients
University of Maryland Anesthesiology Associates, P.a. CurrentSince Mar 1, 2019 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 9, 2018 Accepting new patients
Healthspan Comprehensive Health Adult Health Current Accepting new patients

Locations

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

2401 W Belvedere Ave
Baltimore, MD 21215

611 S Charles St
Baltimore, MD 21230
Phone (410) 328-6331

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

22 S Greene St
Fl 11
Baltimore, MD 21201
Phone (410) 328-6120

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

2200 Kernan Dr
Woodlawn, MD 21207
Phone (410) 448-2500

Interoperability endpoints

  • Direct secure messaging: pnguyen471113@direct.umm.edu

Organizations & group practices 8

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 2

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": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1619479797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST FL 11",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "667-214-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST FL 11",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "667-214-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PETERSON",
        "credential": "PMHNP-BC, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-05",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R217862",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R217862",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R217862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.