Individual provider Active NPI

Derek Nguyen, MD

  • Family Medicine Physician
  • West Hartford, CT
National Provider Identifier
1790954931
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
049412 Issued in CT
Practice address
631 S Quaker LN
West Hartford, CT 06110-1043
Phone
(860) 233-5133
Fax
(860) 233-5211
NPI assigned
Feb 21, 2008
Last updated
Feb 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 049412 CT Primary

Addresses

Primary practice location

631 S Quaker LN
West Hartford, CT 06110-1043

Mailing address

631 S Quaker LN
West Hartford, CT 06110-1043
Phone (860) 233-5133

Other identifiers 1

IdentifierTypeStateIssuer
004236346MedicaidCT

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000040 CT Practitioner - Family PracticePractitioner - Internal Medicine 7416131685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

115 Spencer St
Winsted, CT 06098-1140
Phone (860) 738-5814

631 Quaker S LN
West Hartford, CT 06110-1026
Phone (860) 231-6130

950 Yale Ave
Wallingford, CT 06492-1858
Phone (203) 265-9600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.05 of 100Reported as group
Quality
70.34
Promoting interoperability
100
Improvement activities
40
Cost
75.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
049412CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: derek.nguyen@xdr.hhchealthdirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1790954931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 S QUAKER LN",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101043",
            "telephone_number": "860-233-5133",
            "fax_number": "860-233-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S QUAKER LN",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101043",
            "telephone_number": "860-233-5133",
            "fax_number": "860-233-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DEREK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-21",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "049412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236346",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.