Keoni Nguyen, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

34.010172 Issued in OH

Practice address

4834 Socialville Foster Rd
Mason, OH 45040-6827

Phone

(134) 591-9885

Fax

(513) 459-1845

NPI assigned

Oct 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Thong Tran Nguyen Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

Kansas City University of Physicians and Surgeons, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of Ohio, IncGroup PAC ID 2567427776, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.05 of 100Reported as group

Quality

81.89

Promoting interoperability

100

Improvement activities

40

Cost

71.62

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

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.

• Advanced Dermatology of Ohio, Inc

  • Dermatology Physician
  • Mason, OH
  • NPI 1760491401
  Medicare reassignment Care Compare group NPD
• Mason Dermatology Center Inc

  • Dermatology Physician
  • Mason, OH
  • NPI 1144527060
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1831388198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 COLLINS AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151657",
            "telephone_number": "808-218-9109",
            "fax_number": "740-545-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4834 SOCIALVILLE FOSTER RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450406827",
            "telephone_number": "134-591-9885",
            "fax_number": "513-459-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KEONI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-23",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "34.010172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THONG",
            "last_name": "NGUYEN",
            "middle_name": "TRAN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• New Season of Ohio, LP
• New Season of Ohio, LP
• Serenity Marie Newman
• Charissa Diane Newton, CNM
• Nexgenrx LLC
• Shawn Nichols
• Garvin Nickell, MD
• Jessa Marie Niemeyer, PMHNP
• Brandy Danielle Niemiller, LISW-S
• Nirvana Services LLC

• Dermatology Physician in Mason, OH
• Providers in Mason, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.