Individual provider Active NPI

Anh Tuyet Ngoc Nguyen, MD

  • Student in an Organized Health Care Education/Training Program
  • San Jose, CA
National Provider Identifier
1790135317
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
751 S Bascom Ave
San Jose, CA 95128-2604
Phone
(408) 885-5110
NPI assigned
Jun 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Student in an Organized Health Care Education/Training Program 390200000X Primary
Social Worker 104100000X

Addresses

Primary practice location

751 S Bascom Ave
San Jose, CA 95128-2604

Mailing address

751 S Bascom Ave
San Jose, CA 95128-2699
Phone (408) 885-5110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2001 Winward Way
Suite 101
San Mateo, CA 94404-2499

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Mental Health Center Past Accepting new patients
Tri-City Mental Health Authority PastSince Oct 22, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1790135317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282699",
            "telephone_number": "408-885-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANH TUYET",
        "middle_name": "NGOC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.