Individual provider Active NPI

Phuong Qvoc Mueller, DPM

  • Podiatrist
  • Springdale, AR
National Provider Identifier
1619912110
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
159 Issued in AR
Practice address
1105 Shipley St
Springdale, AR 72764-5453
Phone
(479) 756-6334
Fax
(479) 756-6653
NPI assigned
Jun 18, 2006
Reactivated
Apr 3, 2024
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 159 AR Primary

Addresses

Primary practice location

1105 Shipley St
Springdale, AR 72764-5453

Mailing address

1105 Shipley St
Springdale, AR 72764-5453
Phone (479) 756-2556

Other identifiers 1

IdentifierTypeStateIssuer
131968717MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100507000198 AR Practitioner - Podiatry 7214065556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Physicians LLCGroup PAC ID 0244213213, 36 clinicians

Practice addresses (Care Compare)

601 W Maple Ave
Springdale, AR 72764-5374

609 W Maple Ave
Springdale, AR 72764-5335
Phone (479) 757-8001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.5 of 100Reported as apm
Quality
69.34
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue70
Removal of skin lesions15
Removal of nail tissue40
Removal or shaving of skin growth15
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01248MDMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Physicians LLC CurrentSince May 2, 2024 Accepting new patients
Northwest Physicians LLC CurrentSince May 2, 2024 Accepting new patients

Locations

601 W Maple Ave
Ste 403
Springdale, AR 72764
Phone (479) 750-2742

Interoperability endpoints

  • Direct secure messaging: phuong.mueller.1@2229.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1619912110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SHIPLEY ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645453",
            "telephone_number": "479-756-2556",
            "fax_number": "479-756-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SHIPLEY ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645453",
            "telephone_number": "479-756-6334",
            "fax_number": "479-756-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "PHUONG",
        "middle_name": "QVOC",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2024-04-03",
        "certification_date": "2022-12-29",
        "deactivation_date": "2022-12-29",
        "reactivation_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AR",
            "license": "159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131968717",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.