Johnathan Quan Ba Nguyen

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A161013 Issued in CA

Practice address

3883 Airway Dr Ste 202
Santa Rosa, CA 95403-1671

Phone

(707) 526-3360

Fax

(707) 573-5406

NPI assigned

May 4, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Family PracticeAlso: Sports Medicine

Education

University of Texas Medical Branch at Galveston, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, San Francisco, CA, CCN 057003
• California Pacific Medical Center- Van Ness Campus Hospital, San Francisco, CA, CCN 050047
• California Pacific Medical Ctr-Davies Campus Hosp Hospital, San Francisco, CA, CCN 050008
• California Pacific Medical Center - Mission Bernal Hospital, San Francisco, CA, CCN 050055
• Novato Community Hospital Hospital, Novato, CA, CCN 050131

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jnguyen551083@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1003267196

  Family Medicine

  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1730238007
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Novato, CA
  • NPI 1104059153
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1659439834
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1730238007
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1740348929
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • San Francisco, CA
  • NPI 1437188208
  Care Compare affiliation

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1689020083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "707-521-7777",
            "fax_number": "707-573-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR STE 202",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031671",
            "telephone_number": "707-526-3360",
            "fax_number": "707-573-5406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14023 Southwest Fwy",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774783550",
            "country_code": "US",
            "telephone_number": "281-325-4100",
            "fax_number": "281-325-4292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6801 Park Ter Ste 400",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900459212",
            "country_code": "US",
            "telephone_number": "323-307-8193",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2455 Summerfield Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954057815",
            "country_code": "US",
            "telephone_number": "707-308-2815",
            "fax_number": "707-573-5439",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Hoen Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954057824",
            "country_code": "US",
            "telephone_number": "707-526-3360",
            "fax_number": "707-573-5406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131 Stony Cir Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954019520",
            "country_code": "US",
            "telephone_number": "707-541-7700",
            "fax_number": "707-573-5415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOHNATHAN",
        "middle_name": "QUAN BA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "1169412",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A161013",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A161013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Huynh Nguyen
• Dan Nguyen, PHARMD, RPH
• Deric Nguyen, DDS
• Dinh Khoa Nguyen
• Hang Thi Thu Nguyen
• Katherine Nguyen
• Kevin Tien Nguyen, DDS
• Mariel Buenaflor Nguyen, LVN
• Mei Nguyen
• Minh C Nguyen, PHARM.D.

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.