Individual provider Active NPI

Luc Nguyen, PT

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1821147257
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT33379 Issued in CA
Practice address
1081 S Winchester Blvd
San Jose, CA 95128
Phone
(408) 753-9988
Fax
(408) 899-2656
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT33379 CA Primary

Addresses

Primary practice location

1081 S Winchester Blvd
San Jose, CA 95128

Mailing address

1081 S Winchester Blvd
San Jose, CA 95128
Phone (408) 753-9988

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070219000467 CA Practitioner - Physical Therapist in Private Practice 5092817213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialized Physical Therapy Solutions, IncGroup PAC ID 1355633710, 4 clinicians

Practice addresses (Care Compare)

2200 Lafayette St
Suite 4
Santa Clara, CA 95050-2915
Phone (408) 753-9988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT33379CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Physical Therapy Solutions, Inc. Physical Therapist CurrentSince May 30, 2016 Accepting new patients
Optm Sports & Physical Therapy, Inc Physical Therapist PastSince Jan 1, 2008 Accepting new patients

Locations

2200 Lafayette St
Ste 4
Santa Clara, CA 95050
Phone (408) 753-9988

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1821147257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 S WINCHESTER BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-753-9988",
            "fax_number": "408-899-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 S WINCHESTER BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-753-9988",
            "fax_number": "408-899-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LUC",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT33379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.