Individual provider Active NPI

Minh Thi Nguyen, PA

  • Physician Assistant
  • Winter Park, FL
National Provider Identifier
1790528073
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9119011 Issued in FL
Practice address
133 Benmore Dr Ste 100
Winter Park, FL 32792-4111
Phone
(407) 644-4883
Fax
(407) 644-5445
NPI assigned
Jun 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9119011 FL Primary

Addresses

Primary practice location

133 Benmore Dr Ste 100
Winter Park, FL 32792-4111

Mailing address

18010 Cadence St
Orlando, FL 32820-2727
Phone (407) 722-0149

Other identifiers 1

IdentifierTypeStateIssuer
123463600MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240819001358 FL Practitioner - Physician Assistant 4587102801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Ear Nose and Throat Surgical Associates PAGroup PAC ID 2466437926, 49 clinicians

Practice addresses (Care Compare)

107 The Hermits Trail
Altamonte Sprgs, FL 32701-3619
Phone (407) 834-9120

10920 Moss Park Rd
Suite 224
Orlando, FL 32832-6087
Phone (407) 644-4883

133 Benmore Dr
Suite 100
Winter Park, FL 32792-4111
Phone (407) 644-4883

400 Celebration PL
Suite A120
Celebration, FL 34747-4970
Phone (407) 644-4883

44 W Michigan St
Orlando, FL 32806-4453
Phone (321) 422-4921

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 644-4883

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

Organizations & group practices 1

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 2

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": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1790528073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18010 CADENCE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328202727",
            "telephone_number": "407-722-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-644-4883",
            "fax_number": "407-644-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MINH THI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-14",
        "last_updated": "2025-03-03",
        "certification_date": "2025-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123463600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.