Individual provider Active NPI

Thanh Nguyen, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1689235525
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
403712 Issued in NY
Practice address
1967 Wehrle Dr Ste 1086
Buffalo, NY 14221-8452
Phone
(415) 403-2156
NPI assigned
Jun 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26141 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0993282-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95012142 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP145793 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 403712 NY Primary

Addresses

Primary practice location

1967 Wehrle Dr Ste 1086
Buffalo, NY 14221-8452

Mailing address

340 S Lemon Ave # 9892
Walnut, CA 91789-2706

Other practice location 1

1560 Broadway Ste 1600
Denver, CO 80202-5160
Phone (323) 205-7088

Other practice location 2

301 W 18th St
Merced, CA 95340-4835
Phone (831) 245-3330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, TX, MI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190829001937 TN Practitioner - Nurse Practitioner 9436487337 Reassigns benefits to 1 organization
I20210413000106 TX Practitioner - Nurse Practitioner 9436487337 Reassigns benefits to 1 organization
I20230404001664 MI Practitioner - Nurse Practitioner 9436487337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical PCGroup PAC ID 6608262464, 274 clinicians

Practice addresses (Care Compare)

Knoxville, TN 37923
Phone (415) 360-3348

Austin, TX 78731
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95012142CAMDPsychiatric/Mental Health Nurse Practitioner
AP145793TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical of Michigan PC CurrentSince Feb 13, 2023 Accepting new patients

Locations

2471 Peralta St
Oakland, CA 94607
Phone (614) 208-7845

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

2601 Jackson Ave
#1133
Ann Arbor, MI 48103

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": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1689235525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S LEMON AVE # 9892",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1967 WEHRLE DR STE 1086",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142218452",
            "telephone_number": "415-403-2156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1560 Broadway Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802025160",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 W 18th St",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953404835",
            "country_code": "US",
            "telephone_number": "831-245-3330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THANH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26141",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0993282-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95012142",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP145793",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.