Individual provider Active NPI

Michelle Tuong Minh Nguyen, DPT

  • Physical Therapist
  • Los Altos, CA
National Provider Identifier
1851793319
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
41648 Issued in CA
Practice address
794 Altos Oaks Dr
Los Altos, CA 94024-5401
Phone
(650) 947-9646
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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 41648 CA Primary

Addresses

Primary practice location

794 Altos Oaks Dr
Los Altos, CA 94024-5401

Mailing address

794 Altos Oaks Dr
Los Altos, CA 94024-5401
Phone (650) 947-9646

Other identifiers 1

IdentifierTypeStateIssuer
41648OtherCACA PT LICENSE NUMBER: 41648

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141126001831 CA Practitioner - Physical Therapist in Private Practice 1850613951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shadduck - Physical Therapy Works IncGroup PAC ID 6507259538, 12 clinicians

Practice addresses (Care Compare)

794 Altos Oaks Dr
Los Altos, CA 94024-5401
Phone (650) 947-9646

Merit-based Incentive Payment System (MIPS)

Final score
98.76 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
95.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41648CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Shadduck - Physical Therapy Works Inc Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients

Locations

794 Altos Oaks Dr
Los Altos, CA 94024
Phone (650) 547-9646

Organizations & group practices 1

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": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1851793319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 ALTOS OAKS DR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245401",
            "telephone_number": "650-947-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 ALTOS OAKS DR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245401",
            "telephone_number": "650-947-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MICHELLE",
        "middle_name": "TUONG MINH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "41648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA PT LICENSE NUMBER: 41648",
            "identifier": "41648",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Altos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.