Active NPI
Jackson Nguyen, MD
- Family Medicine Physician
- West Bend, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 73277
- Practice address
- 1700 W Paradise Dr
West Bend, WI 53095-9795 - Phone
- (262) 334-3451
- NPI assigned
- Mar 28, 2018
- Last updated
- Dec 2, 2024
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 73277 | WI | Primary |
Addresses
Primary practice location
1700 W Paradise Dr
West Bend, WI 53095-9795
Mailing address
1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100099356 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451
W168N11237 Western Ave
Germantown, WI 53022-3239
Phone (262) 253-5060
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeshore Medical Clinic, LLC | Family Medicine | Current | Accepting new patients |
| Columbia St. Mary's Hospital Milwaukee, Inc | Family Medicine | Current | Accepting new patients |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| Aurora Advanced Healthcare, Inc. | Family Medicine | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Columbia St. Mary's Hospital Milwaukee Inc | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Aurora Advanced Healthcare Inc | Current | Accepting new patients | |
| Froedtert &the Medical College of Wisconsin Community Physicians, Inc. | Current | Accepting new patients | |
| Ascension Medical Group-Southeast Wisconsin Inc | Family Medicine | Current | Accepting new patients |
Locations
13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400
W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060
2400 W Villard Ave
Glendale, WI 53209
Phone (414) 527-8000
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
2025 W Oklahoma Ave
Ste 100
Milwaukee, WI 53215
Phone (414) 389-2790
2311 N Prospect Ave
Milwaukee, WI 53211
Phone (414) 319-3000
6901 W Edgerton Ave
Milwaukee, WI 53220
Phone (414) 325-5244
2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880
13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300
1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990
201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228
9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000
801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600
1700 W Paradise Dr
West Bend, WI 53095
Phone (262) 334-3451
Interoperability endpoints
- jnguyen684475@direct.froedtert.com
Organizations & group practices 10
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.
-
- Internal Medicine Physician
- Menomonee Falls, WI
- NPI 1568787448
-
dba Ascension Medical Group
- Internal Medicine Physician
- Glendale, WI
- NPI 1609881077
Family Medicine
-
- Family Medicine Physician
- Milwaukee, WI
- NPI 1265629133
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
Family Medicine
-
dba Ascension Columbia St Mary's Hospital Milwaukee
- Multi-Specialty Clinic/Center
- Milwaukee, WI
- NPI 1023064482
Family Medicine
-
- Family Medicine Physician
- St Francis, WI
- NPI 1003861188
-
- Durable Medical Equipment & Medical Supplies
- Summit, WI
- NPI 1477186633
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
dba Ascension Columbia St Mary's Hospital Ozaukee
- Psychiatric Hospital Unit
- Mequon, WI
- NPI 1417600909
-
- Durable Medical Equipment & Medical Supplies
- Wauwatosa, WI
- NPI 1154947224
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CDI-Froedtert Memorial Lutheran Hospital
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1255334173
-
dba Froedtert West Bend Hospital
- General Acute Care Hospital
- West Bend, WI
- NPI 1851336044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1700381977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 W PARADISE DR",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530959795",
"telephone_number": "262-334-3451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 W PARADISE DR",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530959795",
"telephone_number": "262-334-3451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "JACKSON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-28",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "73277",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100099356",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.