Individual provider Active NPI

Jerry Hong Nguyen, CRNA

  • Certified Registered Nurse Anesthetist
  • Fresno, CA
National Provider Identifier
1750114328
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95002433 Issued in CA
Practice address
9479 N Fort Washington Rd Ste 103
Fresno, CA 93730-5939
Phone
(559) 289-4574
NPI assigned
Aug 20, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 95002433 CA Primary

Addresses

Primary practice location

9479 N Fort Washington Rd Ste 103
Fresno, CA 93730-5939

Mailing address

7952 Carlyle Dr
Riverside, CA 92509-6131
Phone (951) 756-0548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241007000923 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981135514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Regional Anesthesia Associates IncGroup PAC ID 3870964323, 143 clinicians

Practice addresses (Care Compare)

1441 Florida Ave
Modesto, CA 95350-4404
Phone (209) 578-1211

Hospital & facility affiliations

  • Emanuel Medical Center Hospital, Turlock, CA, CCN 050179
  • Doctors Hospital of Manteca Hospital, Manteca, CA, CCN 050118
  • Doctors Medical Center Hospital, Modesto, CA, CCN 050464
  • Dameron Hospital Hospital, Stockton, CA, CCN 050122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95002433CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Anesthesia Incorporated Nurse Anesthetist, Certified Registered CurrentSince Aug 25, 2024 Accepting new patients
Valley Regional Anesthesia Associates Inc CurrentSince Aug 12, 2024 Accepting new patients

Locations

3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000

9479 N Fort Washington Rd
Ste 103
Fresno, CA 93730
Phone (559) 289-4574

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

1420 E Roseville Pkwy
Ste 100
Roseville, CA 95661
Phone (916) 677-2488

2800 Benedict Dr
San Leandro, CA 94577
Phone (510) 357-8300

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

580 E Plumb Ln
Reno, NV 89502
Phone (775) 826-7474

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1750114328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7952 CARLYLE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925096131",
            "telephone_number": "951-756-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9479 N FORT WASHINGTON RD STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937305939",
            "telephone_number": "559-289-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JERRY",
        "middle_name": "HONG",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.