NPIMap

Individual provider Active NPI

Mary Phuong Bui

  • Nephrology Physician
  • Upland, CA
National Provider Identifier
1841225224
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20A8116 Issued in CA
Practice address
1317 W Foothill Blvd
Ste 148
Upland, CA 91786-3676
Phone
(909) 981-5882
Fax
(909) 946-0833
NPI assigned
Jul 12, 2006
Last updated
Jan 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 20A8116 CA Primary

Addresses

Primary practice location

1317 W Foothill Blvd
Ste 148
Upland, CA 91786-3676

Mailing address

PO Box 1869
Upland, CA 91785-1869
Phone (909) 981-5882

Other identifiers 1

IdentifierTypeStateIssuer
00AX81160MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050124000619 CA Practitioner - NephrologyPractitioner - Internal Medicine 6103876685 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates of Upland and PomonaGroup PAC ID 2264482744, 6 clinicians

Practice addresses (Care Compare)

1902 Royalty Dr
Suite 230
Pomona, CA 91767-3041
Phone (909) 981-5882

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8116CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upland Vascular Center LLC Nephrology Current Accepting new patients
Upland Vascular Center LLC CurrentSince Nov 16, 2019 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
THC - Orange County, LLC Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Yong Luke Lee Medical Corporation Past Accepting new patients
VHS of Arrowhead, Inc Past Accepting new patients
Dialysis Center of Ontario LLC PastSince May 9, 2005 Accepting new patients
Pinnacle Medical Group, Inc. Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Rancho Cucamonga Community Hospital, LLC Past Accepting new patients
Dignity Health Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients
Erlinda Uy-Concepcion M D Inc Nephrology PastSince Jan 3, 2005 Accepting new patients
Prime Healthcare Services - Montclair, LLC Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Locations

1317 W Foothill Blvd
Ste 110
Upland, CA 91786
Phone (909) 982-4040

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mary.bui.p11@direct.lifelinevascular.nextgenshare.com
  • Direct secure messaging: mary.bui.p151@direct.lifelinevascular.nextgenshare.com
  • Direct secure messaging: mary.bui@direct.davitaphysiciansolutions.com

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 10

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1841225224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1869",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917851869",
            "telephone_number": "909-981-5882",
            "fax_number": "909-385-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 W FOOTHILL BLVD",
            "address_2": "STE 148",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863676",
            "telephone_number": "909-981-5882",
            "fax_number": "909-946-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUI",
        "first_name": "MARY",
        "middle_name": "PHUONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A8116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX81160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.