Individual provider Active NPI

Bang Chau Tran Nguyen, PA-C

  • Medical Physician Assistant
  • Liverpool, NY
National Provider Identifier
1841539954
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9108900 Issued in FL
Practice address
7375 Oswego Rd Ste 1
Liverpool, NY 13090-3717
Phone
(315) 291-0064
NPI assigned
Feb 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 026629-01 NY
Medical Physician Assistant 363AM0700X PA9108900 FL Primary

Addresses

Primary practice location

7375 Oswego Rd Ste 1
Liverpool, NY 13090-3717

Mailing address

18167 US Highway 19 N Ste 650
Clearwater, FL 33764-6576
Phone (727) 437-3006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY, MI, IL, IN, PA6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20151202001916 FL Practitioner - Physician Assistant 7416197256 Reassigns benefits to 6 organizations
I20210524001673 NY Practitioner - Physician Assistant 7416197256 Reassigns benefits to 1 organization
I20210921003402 MI Practitioner - Physician Assistant 7416197256 Reassigns benefits to 2 organizations
I20211014000682 IL Practitioner - Physician Assistant 7416197256 Reassigns benefits to 2 organizations
I20220610000565 IN Practitioner - Physician Assistant 7416197256 Reassigns benefits to 1 organization
I20230718001187 PA Practitioner - Physician Assistant 7416197256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians
Pic Indiana PCGroup PAC ID 3476790239, 143 clinicians

Practice addresses (Care Compare)

446 Fairview Ave
Suite 200
Hudson, NY 12534-1048
Phone (518) 267-3496

4995 Wintersweet Dr
Liverpool, NY 13088-2176
Phone (315) 401-3210

6227 Thompson Rd
Syracuse, NY 13206-1405
Phone (315) 937-2007

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

924 W Pike St
Physicians Urgent Care
Goshen, IN 46526-2365
Phone (574) 312-7056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55826CAMDDentist
026629-01NYMDPhysician Assistant
7519WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Observation Medical Group LLC CurrentSince Jun 15, 2021 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Sep 25, 2015 Accepting new patients
FL-I Medical Services LLC Physician Assistant CurrentSince Sep 25, 2015 Accepting new patients
Adventist Health System Sunbelt, Inc. Physician Assistant CurrentSince Aug 12, 2020 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Aug 12, 2020 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Riverside Recovery of Tampa, LLC Past Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1841539954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18167 US HIGHWAY 19 N STE 650",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337646576",
            "telephone_number": "727-437-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7375 OSWEGO RD STE 1",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130903717",
            "telephone_number": "315-291-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "BANG CHAU",
        "middle_name": "TRAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-08",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026629-01",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.