Individual provider Active NPI

Thu A Nguyen, M.D.

  • Neurology Physician
  • American Fork, UT
National Provider Identifier
1649204389
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
227688 Issued in MA
Practice address
1175 E 50 S
Suite 161
American Fork, UT 84003-2845
Phone
(801) 492-5992
Fax
(801) 812-5439
NPI assigned
Jul 10, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 227688 MA Primary

Addresses

Primary practice location

1175 E 50 S
Suite 161
American Fork, UT 84003-2845

Mailing address

1055 N 500 W
Attn: Credentialing
Provo, UT 84604-3305
Phone (801) 354-8225

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Revere Health PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20071220000154 UT Practitioner - Neurology 3476643909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Mayo Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

1175 E 50
Suite 211
American Fork, UT 84003-2845
Phone (801) 418-0807

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227688MAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Dec 31, 2007 Accepting new patients
Revere Health PC CurrentSince Dec 31, 2007 Accepting new patients

Locations

1175 E 50 S
#161
American Fork, UT 84003

1175 E 50 S
Ste 161
American Fork, UT 84003
Phone (801) 377-4623

1175 E 50 S
Ste 211
American Fork, UT 84003
Phone (801) 418-0807

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

Interoperability endpoints

  • Direct secure messaging: thunguyen@cuccu.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1649204389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 E 50 S",
            "address_2": "SUITE 161",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032845",
            "telephone_number": "801-492-5992",
            "fax_number": "801-812-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THU",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-11-27",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "227688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "1175 E 50 S",
            "address_2": "Suite 161",
            "city": "American Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840032845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.