Individual provider Active NPI

Nick Nguyen

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1679331367
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
353772 Issued in NY
Practice address
10 E 102ND St
New York, NY 10029-0307
Phone
(212) 241-6756
NPI assigned
Mar 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12888 CT
Family Nurse Practitioner 363LF0000X 353772 NY Primary

Addresses

Primary practice location

10 E 102ND St
New York, NY 10029-0307

Mailing address

10 E 102ND St
New York, NY 10029-0307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709000842 CT Practitioner - Nurse Practitioner 1951846534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivx Health of Connecticut PCGroup PAC ID 1658753967, 8 clinicians

Practice addresses (Care Compare)

596 Westport Ave
Norwalk, CT 06851-4439
Phone (475) 208-2111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12888CTMDClinical Social Worker
353772NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ivx Health of Connecticut PC Family CurrentSince Jun 5, 2024 Accepting new patients
Liv Specialty Care CT PC CurrentSince Feb 15, 2025 Accepting new patients

Locations

119 Hebron Ave
#B
Glastonbury, CT 06033
Phone (860) 996-8117

1455 Whalley Ave
New Haven, CT 06515
Phone (203) 941-5429

596 Westport Ave
Norwalk, CT 06851
Phone (203) 229-0075

263 Boston Post Rd
Ste 7
Orange, CT 06477
Phone (860) 996-8226

1111 Cromwell Ave
Ste 301
Rocky Hill, CT 06067
Phone (860) 244-8857

18 Kane St
Unit A
West Hartford, CT 06119
Phone (860) 891-6742

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1679331367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 E 102ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100290307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E 102ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100290307",
            "telephone_number": "212-241-6756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12888",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.