Individual provider Active NPI

Tommy Nguyen, PA

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1740966357
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2871 Saint Rose Pkwy Ste 130
Henderson, NV 89052-4806
Phone
(702) 430-5333
NPI assigned
Jun 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2871 Saint Rose Pkwy Ste 130
Henderson, NV 89052-4806

Mailing address

3236 Monte Luna Ave
Henderson, NV 89044-1873
Phone (781) 336-8147

Other practice location 1

1801 Mesquite Ave
Lake Havasu City, AZ 86403-5668
Phone (928) 377-4540

Other practice location 2

15 Musket Rd
Plymouth, MA 02360-5019
Phone (781) 336-8147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, AZ2 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

Enrollment IDStateProvider typePAC IDDetails
I20230926001484 NV Practitioner - Physician Assistant 9931553989 Reassigns benefits to 2 organizations
I20250213003280 AZ Practitioner - Physician Assistant 9931553989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas DermatologyGroup PAC ID 9830277136, 35 clinicians

Practice addresses (Care Compare)

1801 Mesquite Ave
Lake Havasu City, AZ 86403-5668
Phone (928) 854-5400

9097 W Post Rd
Suite 100
Las Vegas, NV 89148-2417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen William Doggett, M.D. PA PastSince Nov 29, 2023 Accepting new patients
Douglas a. Thomas, MD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tommyn@thomasderm.emadirect.md

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1740966357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 MONTE LUNA AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890441873",
            "telephone_number": "781-336-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2871 SAINT ROSE PKWY STE 130",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524806",
            "telephone_number": "702-430-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Mesquite Ave",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864035668",
            "country_code": "US",
            "telephone_number": "928-377-4540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Musket Rd",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MA",
            "postal_code": "023605019",
            "country_code": "US",
            "telephone_number": "781-336-8147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TOMMY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.