Kathlene Manimtim Nguyen

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95020377 Issued in CA

Practice address

7159 Myrtle PL
Fontana, CA 92336-5706

Phone

(619) 415-9181

NPI assigned

Mar 29, 2022

Last updated

Mar 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathlene Villegas Manimtim Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathlene.nguyen@682114225012740.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pair Team Medical Group of California PC

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1134838352
  Medicare reassignment NPD
• Pair Team Medical Group, P.a.

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1659132553
  Medicare reassignment NPD

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1699415620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7159 MYRTLE PL",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365706",
            "telephone_number": "619-415-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7159 MYRTLE PL",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365706",
            "telephone_number": "619-415-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KATHLENE",
        "middle_name": "MANIMTIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95020377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLENE",
            "last_name": "MANIMTIM",
            "middle_name": "VILLEGAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Huy Nguyen, PHARM.D.
• Huy Quang Nguyen
• J Duc Ngoc Nguyen, M.D.
• Jennifer Ho Nguyen, O.D.
• Jimmy Nguyen
• Khoa Anh Nguyen, MD
• Kim Bich Thi Nguyen
• Loc Nguyen, MD
• Marilyn Maia Nguyen
• Ngoc Patrick V Nguyen, MD

• Nurse Practitioner in Fontana, CA
• Providers in Fontana, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.