NPIMap

Individual provider Active NPI

Si Van Nguyen, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Garden Grove, CA
National Provider Identifier
1841234952
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A48904 Issued in CA
Practice address
12601 Garden Grove Blvd
Pathology Dept.
Garden Grove, CA 92843-1908
Phone
(949) 874-0827
Fax
(310) 698-7054
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A48904 CA Primary

Addresses

Primary practice location

12601 Garden Grove Blvd
Pathology Dept.
Garden Grove, CA 92843-1908

Mailing address

20001 S Rancho Way
Rancho Dominguez, CA 90220-6318
Phone (310) 225-3244

Other identifiers 1

IdentifierTypeStateIssuer
00A489040MedicaidCA

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
I20040414001095 CA Practitioner - Pathology 3476547092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Medical School at San Antonio, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garden Grove Pathology Medical Group PCGroup PAC ID 2769966357, 2 clinicians
Affiliated Pathologists Medical Group, Inc.Group PAC ID 7315840535, 46 clinicians

Practice addresses (Care Compare)

12601 Garden Grove Blvd
Garden Grove, CA 92843-1908
Phone (949) 874-0827

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.39 of 100Reported as group
Quality
88.62
Improvement activities
40
Cost
77.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48904CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Garden Grove Pathology Medical Group PC Anatomic Pathology & Clinical Pathology CurrentSince Oct 12, 2025 Accepting new patients
Soc Pathology Medical Group Inc. Anatomic Pathology & Clinical Pathology PastSince May 6, 2014 Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients

Locations

12601 Garden Grove Blvd
Garden Grove, CA 92843
Phone (714) 537-5160

17772 Beach Blvd
Huntington Beach, CA 92647
Phone (714) 842-1473

7901 Walker St
La Palma, CA 90623
Phone (562) 424-2900

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1841234952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20001 S RANCHO WAY",
            "city": "RANCHO DOMINGUEZ",
            "state": "CA",
            "postal_code": "902206318",
            "telephone_number": "310-225-3244",
            "fax_number": "310-698-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12601 GARDEN GROVE BLVD",
            "address_2": "PATHOLOGY DEPT.",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431908",
            "telephone_number": "949-874-0827",
            "fax_number": "310-698-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "SI",
        "middle_name": "VAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A48904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A489040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.