Individual provider Active NPI

Mimi Nguyen

  • Dermatology Physician
  • Sacramento, CA
National Provider Identifier
1770082943
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A178402 Issued in CA
Practice address
2951 Benefit Way
Sacramento, CA 95834-1272
Phone
(916) 285-8165
Fax
(916) 285-8175
NPI assigned
Feb 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A178402 CA Primary

Addresses

Primary practice location

2951 Benefit Way
Sacramento, CA 95834-1272

Mailing address

2951 Benefit Way
Sacramento, CA 95834-1272
Phone (916) 285-8165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807002371 CA Practitioner - Dermatology 4587025515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of California, Davis School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.39 of 100Reported as group
Quality
75.67
Promoting interoperability
100
Improvement activities
40
Cost
74.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions292
Removal or shaving of skin growth1-10
Skin biopsy173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A178402CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Dermatology Current Accepting new patients
Permanente Medical Group Inc Dermatology CurrentSince Jun 26, 2023 Accepting new patients
Sutter Valley Medical Foundation Dermatology Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Jun 26, 2023 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Sep 1, 2024 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Sep 1, 2024 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

275 W MacArthur Blvd
Piedmont, CA 94611
Phone (510) 752-1375

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

6600 Bruceville Rd
Sacramento, CA 95823

2951 Benefit Way
Sacramento, CA 95834
Phone (916) 285-8100

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Interoperability endpoints

  • Direct secure messaging: mnguyen690432@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1770082943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951 BENEFIT WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341272",
            "telephone_number": "916-285-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 BENEFIT WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341272",
            "telephone_number": "916-285-8165",
            "fax_number": "916-285-8175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MIMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A178402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.