Individual provider Active NPI

Macklin Hong Phuoc Nguyen, MD

  • Radiation Oncology Physician
  • Rockford, IL
National Provider Identifier
1669931713
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
036-172332 Issued in IL
Practice address
3535 N Bell School Rd
Rockford, IL 61114-6624
Phone
(779) 696-9400
Fax
(779) 696-9365
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Radiation Oncology Physician 2085R0001X 036-172332 IL Primary

Addresses

Primary practice location

3535 N Bell School Rd
Rockford, IL 61114-6624

Mailing address

9260 W Sunset Rd Ste 110
Las Vegas, NV 89148-4903
Phone (702) 916-6904

Other practice location 1

9300 W Sunset Rd
Las Vegas, NV 89148-4844
Phone (702) 916-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20241031001843 IL Practitioner - Radiation Oncology 1456687896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Washington School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

3535 N Bell School Rd
Regional Cancer Center
Rockford, IL 61114-6624
Phone (779) 696-9400

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-172332ILMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital CurrentSince Oct 24, 2024 Accepting new patients
Swedishamerican Hospital Current Accepting new patients
Swedishamerican Hospital Radiation Oncology CurrentSince Oct 24, 2024 Accepting new patients

Locations

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

3535 N Bell School Rd
Rockford, IL 61114
Phone (779) 696-9400

Organizations & group practices 3

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1669931713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9260 W SUNSET RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484903",
            "telephone_number": "702-916-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 N BELL SCHOOL RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146624",
            "telephone_number": "779-696-9400",
            "fax_number": "779-696-9365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 W Sunset Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891484844",
            "country_code": "US",
            "telephone_number": "702-916-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MACKLIN",
        "middle_name": "HONG PHUOC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036-172332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.