Individual provider Active NPI

George Van Nguyen, MD

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1629698907
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
69754 Issued in AZ
Practice address
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone
(602) 839-2000
NPI assigned
Apr 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 69754 AZ Primary

Addresses

Primary practice location

1111 E McDowell Rd
Phoenix, AZ 85006-2612

Mailing address

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230908000831 AZ Practitioner - Internal Medicine 7012331119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arizona College of Medicine - Phoenix, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner - University Primary Care Physicians LLCGroup PAC ID 2365746450, 45 clinicians

Practice addresses (Care Compare)

4200 E Camelback Rd
Suite 202
Phoenix, AZ 85018-2718
Phone (602) 229-2200

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
69754AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner -- University Primary Care Physicians LLC CurrentSince Aug 18, 2023 Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1300 N 12th St
Ste 500
Phoenix, AZ 85006
Phone (602) 839-2606

4200 E Camelback Rd
Ste 202
Phoenix, AZ 85018
Phone (602) 229-2150

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

Organizations & group practices 1

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 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": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1629698907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-839-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-839-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "GEORGE",
        "middle_name": "VAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-16",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "69754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.