Individual provider Active NPI

Minh Ngo, PA

  • Physician Assistant
  • Taylor, TX
National Provider Identifier
1689107294
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11036 Issued in TX
Practice address
305 Mallard LN
Taylor, TX 76574-1208
Phone
(512) 352-7611
NPI assigned
Apr 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA11036 TX Primary
Physician Assistant 363A00000X 53945 CA

Addresses

Primary practice location

305 Mallard LN
Taylor, TX 76574-1208

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371

Other practice location 1

12218 Ashford Valley Dr
Sugar Land, TX 77478-6143
Phone (832) 495-2288

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mngo1303608@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170616000970 TX Practitioner - Physician Assistant 6800164740 Reassigns benefits to 8 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
53945CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Hospital - Taylor CurrentSince Jun 20, 2023 Accepting new patients
Scott & White Clinic CurrentSince Mar 13, 2024 Accepting new patients
Methodist Health Centers Past Accepting new patients

Locations

300 University Blvd
Bldg A
Round Rock, TX 78665
Phone (512) 509-0100

305 Mallard Ln
Taylor, TX 76574
Phone (512) 352-7611

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

Organizations & group practices 9

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1689107294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "800-994-0371",
            "fax_number": "254-215-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MALLARD LN",
            "city": "TAYLOR",
            "state": "TX",
            "postal_code": "765741208",
            "telephone_number": "512-352-7611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12218 Ashford Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774786143",
            "country_code": "US",
            "telephone_number": "832-495-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGO",
        "first_name": "MINH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11036",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53945",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mngo1303608@direct.sw.org",
            "affiliation": "N",
            "address_1": "305 Mallard Ln",
            "city": "Taylor",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765741208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Taylor, TX

Sources for this page

Verify at the official NPI Registry.