Active NPI
Jay Nguyen
- Dermatology Physician
- Maitland, FL
National Provider Identifier
1780324798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- UO8274
- Practice address
- 151 Southhall LN Ste 300
Maitland, FL 32751-7172 - Phone
- (866) 400-3376
- NPI assigned
- Mar 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | UO8274 | FL | Primary |
Addresses
Primary practice location
151 Southhall LN Ste 300
Maitland, FL 32751-7172
Mailing address
151 Southhall LN Ste 300
Maitland, FL 32751-7172
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220730000097 | FL | Order and Referring Only - Dermatology | 7012399504 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UO8274 | FL | MD | Dermatology Physician |
Interoperability endpoints
- jay.nguyen@hca5.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703289600000",
"number": "1780324798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 SOUTHHALL LN STE 300",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327517172",
"fax_number": "904-639-2015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 SOUTHHALL LN STE 300",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327517172",
"telephone_number": "866-400-3376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "JAY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-29",
"last_updated": "2023-12-23",
"certification_date": "2023-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "FL",
"license": "UO8274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maitland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.