Active NPI
Minh-Tuan Richard Hoang, M.D.
- Procedural Dermatology Physician
- Port Orchard, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Procedural Dermatology Physician
- License
- MD60604269
- Practice address
- 1400 Pottery Ave
Port Orchard, WA 98366-3711 - Phone
- (360) 895-5000
- Fax
- (360) 895-5034
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | A65177 | CA | |
| Procedural Dermatology Physician | 207NS0135X | MD60604269 | WA | Primary |
Addresses
Primary practice location
1400 Pottery Ave
Port Orchard, WA 98366-3711
Mailing address
1400 Pottery Ave
Port Orchard, WA 98366-3768
Phone (360) 895-5000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65177 | CA | MD | Marriage & Family Therapist |
| A65177 | CA | MD | Procedural Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Academy Skin Physicians, Inc. | Procedural Dermatology | Current | Accepting new patients |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Coastal Medical and Cosmetic Dermatology Inc | Past | Accepting new patients |
Locations
4520 Executive Dr
Ste 325
San Diego, CA 92121
Phone (858) 346-2065
1400 Pottery Ave
Port Orchard, WA 98366
Phone (360) 895-5000
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Interoperability endpoints
- mhoang252450@ghc.direct-ci.net
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1124264577
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
-
- MOHS-Micrographic Surgery Physician
- San Diego, CA
- NPI 1447296363
Procedural Dermatology
-
- Dermatology Physician
- La Jolla, CA
- NPI 1346488004
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618272000000",
"number": "1699716860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 POTTERY AVE",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983663768",
"telephone_number": "360-895-5000",
"fax_number": "360-895-5034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 POTTERY AVE",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983663711",
"telephone_number": "360-895-5000",
"fax_number": "360-895-5034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOANG",
"first_name": "MINH-TUAN",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "CA",
"license": "A65177",
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "WA",
"license": "MD60604269",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1400 Pottery Ave",
"city": "Port Orchard",
"state": "WA",
"country_code": "US",
"postal_code": "983663711",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Port Orchard, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.