Individual provider Active NPI

Thucuc Thi-Thu Nguyen, M.D.

  • Psychiatry Physician
  • Mercer Island, WA
National Provider Identifier
1699824110
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD00026682 Issued in WA
Practice address
9725 SE 36TH St
Suite
Mercer Island, WA 98040-3841
Phone
(206) 236-5553
Fax
(206) 236-0506
NPI assigned
Jan 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD00026682 WA Primary

Addresses

Primary practice location

9725 SE 36TH St
Suite
Mercer Island, WA 98040-3841

Mailing address

9725 SE 36TH St
Suite
Mercer Island, WA 98040-3841
Phone (206) 236-5553

Other identifiers 2

IdentifierTypeStateIssuer
4308909OtherAETNA PIN #
NG5663OtherREGENCE PIN#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Aug 3, 2015 through Aug 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Center & Clinics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699824110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9725 SE 36TH ST",
            "address_2": "SUITE",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403841",
            "telephone_number": "206-236-5553",
            "fax_number": "206-236-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9725 SE 36TH ST",
            "address_2": "SUITE",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403841",
            "telephone_number": "206-236-5553",
            "fax_number": "206-236-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THUCUC",
        "middle_name": "THI-THU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00026682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN #",
            "identifier": "4308909",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PIN#",
            "identifier": "NG5663",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mercer Island, WA

Sources for this page

Verify at the official NPI Registry.