Individual provider Active NPI

Trieu Dang, DPM

  • Podiatrist
  • Jacksonville, FL
National Provider Identifier
1801204755
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PR 374 Issued in FL
Practice address
2627 Riverside Ave
Jacksonville, FL 32204-4712
Phone
(904) 308-7909
NPI assigned
Jul 23, 2014
Last updated
Jul 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PR 374 FL Primary

Addresses

Primary practice location

2627 Riverside Ave
Jacksonville, FL 32204-4712

Mailing address

2627 Riverside Ave
Jacksonville, FL 32204-4712
Phone (904) 308-7909

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180216002322 FL Practitioner - Podiatry 2769743558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8495 Normandy Blvd
Jacksonville, FL 32221-6701
Phone (904) 783-3749

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue126
Removal of skin lesions1-10
Removal of nail tissue163
Removal or shaving of skin growth136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR 374FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Trieu Foot Solutions LLC Podiatrist CurrentSince Feb 28, 2019 Accepting new patients

Locations

8495 Normandy Blvd
Jacksonville, FL 32221
Phone (570) 352-3063

609 5th St SW
Live Oak, FL 32064
Phone (386) 219-0171

609 5th St SW
Ste 4
Live Oak, FL 32064
Phone (352) 376-5112

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBGGBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CBGGBD/Endpoint/CBGGBD

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, 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": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1801204755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044712",
            "telephone_number": "904-308-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044712",
            "telephone_number": "904-308-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "TRIEU",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PR 374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.