Tri Ngoc Dam, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95006901 Issued in CA

Practice address

87 N 6TH St
San Jose, CA 95112-5423

Phone

(408) 279-1180

Fax

(408) 279-6745

NPI assigned

Feb 21, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  NPD

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

{
    "created_epoch": "1613865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613865600000",
    "number": "1649864604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20449 TIMES AVE",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945413745",
            "telephone_number": "510-304-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 N 6TH ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125423",
            "telephone_number": "408-279-1180",
            "fax_number": "408-279-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAM",
        "first_name": "TRI",
        "middle_name": "NGOC",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-21",
        "last_updated": "2021-02-21",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Anngoctomd@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "Office address",
            "address_1": "87 N 6th St",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951125423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura Elizabeth Dalton, D.O.
• John Peter Daly, M.D.
• Dinh X Dam, M.D.
• Jessica Quan Dam
• Thu Anh Dam
• Rayna Damacion
• Edmundo Nicanor Damasco, RPH
• Evelyn Marie Damate-Senga, PHARMD
• Sandra Karinie Damian
• Edward Damore, MD

• Family Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.