Individual provider Active NPI

Tran Nguyen

  • Family Nurse Practitioner
  • West Hartford, CT
National Provider Identifier
1770054595
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8055 Issued in CT
Practice address
65 Memorial Rd Ste 508
West Hartford, CT 06107-4233
Phone
(860) 696-2925
NPI assigned
Dec 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 101155 CT
Family Nurse Practitioner 363LF0000X 8055 CT Primary

Addresses

Primary practice location

65 Memorial Rd Ste 508
West Hartford, CT 06107-4233

Mailing address

65 Memorial Rd Ste 508
West Hartford, CT 06107-4233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190222001662 CT Practitioner - Nurse Practitioner 7719226570 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101155CTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Headache Care Center PLLC CurrentSince Dec 1, 2022 Accepting new patients
Hartford Healthcare Medical Group, Inc CurrentSince Mar 1, 2019 Accepting new patients
MWL-Wethersfield PastSince Aug 1, 2020 Accepting new patients
MJS One, LLC Past Accepting new patients

Locations

1741 Ellington Rd
Ste 1
South Windsor, CT 06074
Phone (860) 263-3603

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

65 Memorial Rd
Ste 508
West Hartford, CT 06107

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Organizations & group practices 6

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": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1770054595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MEMORIAL RD STE 508",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061074233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MEMORIAL RD STE 508",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061074233",
            "telephone_number": "860-696-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "101155",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.