Individual provider Active NPI

Andrea Tram Anh Quan Huynh, MD

  • Family Medicine Physician
  • San Jose, CA
National Provider Identifier
1669056040
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
199303 Issued in CA
Practice address
57 N 13TH St
San Jose, CA 95112-3439
Phone
(408) 998-3075
NPI assigned
May 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 199303 CA Primary

Addresses

Primary practice location

57 N 13TH St
San Jose, CA 95112-3439

Mailing address

57 N 13TH St
San Jose, CA 95112-3439
Phone (408) 998-3075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250519000922 CA Order and Referring Only - Family PracticePractitioner - Family Practice 1052713104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
199303CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Huynh Primary Care Inc Single Specialty CurrentSince Jan 19, 2025 Accepting new patients

Locations

57 N 13th St
San Jose, CA 95112
Phone (408) 998-3075

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.

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1669056040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 N 13TH ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951123439",
            "telephone_number": "408-998-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 N 13TH ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951123439",
            "telephone_number": "408-998-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "ANDREA TRAM ANH",
        "middle_name": "QUAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "199303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.