Individual provider Active NPI

Khoa V Nguyen, PT

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1801567151
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2120 Orinoco Dr Ste 200
Orlando, FL 32837-8932
Phone
(407) 916-6167
NPI assigned
Sep 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2120 Orinoco Dr Ste 200
Orlando, FL 32837-8932

Mailing address

1825 Snaresbrook Way
Orlando, FL 32837-6585
Phone (407) 916-6167

Other practice location 1

1301 E M St
Torrington, WY 82240-3521
Phone (307) 532-5355

Other practice location 2

3315 10th St
Gering, NE 69341-1731
Phone (308) 633-5361

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL khoa.nguyen@maxperformancetherapy.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260123000756 FL Practitioner - Physical Therapist in Private Practice 9133512767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1825 Snaresbrook Way
Orlando, FL 32837-6585

PO Box
Suite 290609
Nashville, TN 37229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Physical Therapy, LLC Single Specialty CurrentSince Oct 1, 2021 Accepting new patients
Florida Luna Care Physical Therapy LLC Single Specialty CurrentSince Jan 15, 2026 Accepting new patients
Max Performance Therapy CurrentSince Dec 6, 2022 Accepting new patients
Memorial Hospital of Converse County Single Specialty PastSince Oct 5, 2021 Accepting new patients
North Platte Physical Therapy Services, Inc. Single Specialty PastSince Oct 5, 2021 Accepting new patients

Locations

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

2120 Orinoco Dr
Ste 200
Orlando, FL 32837
Phone (407) 916-6167

3315 10th St
Gering, NE 69341
Phone (308) 633-5361

Organizations & group practices 5

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": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1801567151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 SNARESBROOK WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376585",
            "telephone_number": "407-916-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 ORINOCO DR STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378932",
            "telephone_number": "407-916-6167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 E M St",
            "address_purpose": "LOCATION",
            "city": "Torrington",
            "state": "WY",
            "postal_code": "822403521",
            "country_code": "US",
            "telephone_number": "307-532-5355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3315 10th St",
            "address_purpose": "LOCATION",
            "city": "Gering",
            "state": "NE",
            "postal_code": "693411731",
            "country_code": "US",
            "telephone_number": "308-633-5361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KHOA",
        "middle_name": "V",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "khoa.nguyen@maxperformancetherapy.com",
            "affiliation": "N",
            "address_1": "2120 Orinoco Dr Ste 200",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328378932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.