Organization Active NPI

Ngoc Nguyen MD Inc

  • Ophthalmology Physician
  • San Jose, CA
National Provider Identifier
1639238140
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G070053 Issued in CA
Legal business name
NGOC NGUYEN MD INC
Practice address
2380 Montpelier Dr Ste 300
San Jose, CA 95116-1620
Phone
(408) 272-3706
Fax
(408) 254-4094
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nguyen Nguyen, M.D.
Title
Owner
Phone
(408) 272-3706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G070053 CA Primary

Addresses

Primary practice location

2380 Montpelier Dr Ste 300
San Jose, CA 95116-1620

Mailing address

2380 Montpelier Dr Ste 300
San Jose, CA 95116-1620
Phone (408) 272-3706

Other identifiers 1

IdentifierTypeStateIssuer
GR0093880MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041203000717 CA Part B Supplier - Clinic/Group Practice 0749246502 Receives reassigned benefits from 3 practitioners
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ECHGBD

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639238140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 MONTPELIER DR STE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161620",
            "telephone_number": "408-272-3706",
            "fax_number": "408-254-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 MONTPELIER DR STE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161620",
            "telephone_number": "408-272-3706",
            "fax_number": "408-254-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGOC NGUYEN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "NGUYEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-272-3706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G070053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0093880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.