Individual provider Active NPI

Antony Nguyen Vanbang, MD

  • General Practice Physician
  • Denver, CO
National Provider Identifier
1679747216
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
DR.0054747 Issued in CO
Practice address
1701 S Federal Blvd # D
Denver, CO 80219-4898
Phone
(303) 936-1760
Fax
(303) 934-4036
NPI assigned
Apr 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X DR.0054747 CO Primary
General Practice Physician 208D00000X 13674 NE

Addresses

Primary practice location

1701 S Federal Blvd # D
Denver, CO 80219-4898

Mailing address

1701 S Federal Blvd # D
Denver, CO 80219-4898
Phone (303) 936-1760

Other identifiers 1

IdentifierTypeStateIssuer
9000138028MedicaidCO

Other names 1

  • Bang Nguyen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20171003006579 CO Practitioner - Family PracticePractitioner - General PracticePractitioner - Internal MedicinePractitioner - Geriatric MedicinePractitioner - Addiction Medicine 4587730387

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0054747COMDGeneral Practice Physician
13674NEMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Medical Center Current Accepting new patients
Urgent Care 9 to 9 PastSince Mar 13, 2022 Accepting new patients

Locations

1701 S Federal Blvd
#D
Denver, CO 80219
Phone (303) 936-1760

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": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1679747216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 S FEDERAL BLVD # D",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802194898",
            "telephone_number": "303-936-1760",
            "fax_number": "303-934-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S FEDERAL BLVD # D",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802194898",
            "telephone_number": "303-936-1760",
            "fax_number": "303-934-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBANG",
        "first_name": "ANTONY NGUYEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CO",
            "license": "DR.0054747",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "13674",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000138028",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BANG",
            "last_name": "NGUYEN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.