Individual provider Active NPI

Thien Quang Nguyen, PA-C

  • Medical Physician Assistant
  • Austin, TX
National Provider Identifier
1760885792
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA09536 Issued in TX
Practice address
5915 La Crosse Avneue
BLDG 2, Ste 140
Austin, TX 78739-1783
Phone
(503) 300-4111
Fax
(503) 954-2122
NPI assigned
Oct 5, 2014
Last updated
Nov 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA09536 TX Primary

Addresses

Primary practice location

5915 La Crosse Avneue
BLDG 2, Ste 140
Austin, TX 78739-1783

Mailing address

5915 La Crosse Avneue
BLDG 2, Ste 140
Austin, TX 78739-1783
Phone (503) 300-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WY2 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
I20150303001808 TX Practitioner - Physician Assistant 8729304076 Reassigns benefits to 3 organizations
I20210602001389 WY Practitioner - Physician Assistant 8729304076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stgi Health, LLCGroup PAC ID 1850764226, 15 clinicians

Practice addresses (Care Compare)

2126 Opal Ave
Yellowstone National Park, WY 82190
Phone (703) 578-6030

Old Faithful Clinic 122 Clinic LN
Yellowstone National Park, WY 82190
Phone (703) 578-6030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA09536TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jan 25, 2015 Accepting new patients
Baylor College of Medicine CurrentSince Jan 25, 2015 Accepting new patients
Medcor of Barrington, P.C. CurrentSince May 14, 2021 Accepting new patients
Pacific Crest Childrens Urgent Care LLC PastSince Nov 19, 2023 Accepting new patients

Locations

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

Organizations & group practices 7

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": "1412467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1760885792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5915 LA CROSSE AVNEUE",
            "address_2": "BLDG 2, STE 140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787391783",
            "telephone_number": "503-300-4111",
            "fax_number": "503-954-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5915 LA CROSSE AVNEUE",
            "address_2": "BLDG 2, STE 140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787391783",
            "telephone_number": "503-300-4111",
            "fax_number": "503-954-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THIEN",
        "middle_name": "QUANG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-05",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA09536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.