Jimmy Khang Nguyen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3059 Voyager Dr
Green Bay, WI 54311-8303

Phone

(920) 965-0345

NPI assigned

Nov 14, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, MI2 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 2

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Dermatology Group LTDGroup PAC ID 9537312665, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jimmy.nguyen.1@23194.direct.athenahealth.com

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.

• New Dermatology Group LTD

  • Dermatology Physician
  • Howard, WI
  • NPI 1235480112

  MI

  Medicare reassignment Care Compare group NPD
• New Dermatology Group LTD

  • Dermatology Physician
  • Iron Mountain, MI
  • NPI 1710321633
  NPD (past)

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

{
    "created_epoch": "1763078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1730049552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3059 VOYAGER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 VOYAGER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118303",
            "telephone_number": "920-965-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JIMMY",
        "middle_name": "KHANG",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-14",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon E Newell, DDS
• David C Newell, MD
• Newisconsin MRI Center of Green Bay LLC
• John Graham Newman, D.D.S., M.S.
• Nexora Medical Transport LLC
• Thuy Nguyen, DMD
• Vannhu Nguyen, M.D.
• Shay Nicholas, M.D.
• Amanda Nichols, APNP
• Katelyn Ellen Nichols, PHARMD

• Physician Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.