Individual provider Active NPI

Nicole Ngan Nguyen, DNP

  • Family Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1619647328
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61208734 Issued in WA
Practice address
750 Republican St BLDG F2ND
Seattle, WA 98109-4766
Phone
(206) 485-9000
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AP61208734 WA
Nurse Practitioner 363L00000X AP61208734 WA
Nurse Practitioner 363L00000X APN.0998521-NP CO
Family Nurse Practitioner 363LF0000X APN.0998521-NP CO
Family Nurse Practitioner 363LF0000X AP61208734 WA Primary

Addresses

Primary practice location

750 Republican St BLDG F2ND
Seattle, WA 98109-4766

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other practice location 1

16280 W 64th Ave
Arvada, CO 80007-7413
Phone (720) 898-1110

Other identifiers 1

IdentifierTypeStateIssuer
1619647328MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240215004148 CO Practitioner - Nurse Practitioner 8123416716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

16280 W 64TH Ave
Adnh Sportsandfamily Arv
Arvada, CO 80007-7413
Phone (720) 898-1110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61208734WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Feb 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Feb 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients

Locations

16280 W 64th Ave
Arvada, CO 80007
Phone (720) 898-1110

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1619647328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 REPUBLICAN ST BLDG F2ND",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094766",
            "telephone_number": "206-485-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16280 W 64th Ave",
            "address_purpose": "LOCATION",
            "city": "Arvada",
            "state": "CO",
            "postal_code": "800077413",
            "country_code": "US",
            "telephone_number": "720-898-1110",
            "fax_number": "720-898-1113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NICOLE",
        "middle_name": "NGAN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "AP61208734",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61208734",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0998521-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0998521-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61208734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619647328",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.