Individual provider Active NPI

Khoa Dinh Truong, DO

  • Family Medicine Physician
  • Mount Vernon, WA
National Provider Identifier
1851882146
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61215451 Issued in WA
Practice address
2116 E Section St
Mount Vernon, WA 98274-9124
Phone
(360) 428-1700
NPI assigned
May 23, 2018
Last updated
Nov 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58.030435 OH
Family Medicine Physician 207Q00000X OP61215451 WA Primary

Addresses

Primary practice location

2116 E Section St
Mount Vernon, WA 98274-9124

Mailing address

2116 E Section St
Mount Vernon, WA 98274-9124
Phone (360) 428-1700

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250106001984 TX Practitioner - Family Practice 2062769870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulalip Tribes of WashingtonGroup PAC ID 7719879782, 24 clinicians

Practice addresses (Care Compare)

7520 Totem Beach Rd
Tulalip, WA 98271-6160
Phone (360) 716-4511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP61215451WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Network PLLC Multi-Specialty Current Accepting new patients
Family Care Network PLLC Multi-Specialty CurrentSince Nov 1, 2021 Accepting new patients
Family Care Network PLLC Multi-Specialty CurrentSince Nov 1, 2021 Accepting new patients
Tulalip Tribes of Washington Multi-Specialty CurrentSince Jan 6, 2025 Accepting new patients
Tulalip Tribes of Washington Multi-Specialty CurrentSince Jan 6, 2025 Accepting new patients

Locations

1610 Grover St
Ste D1
Lynden, WA 98264
Phone (360) 312-3785

2116 E Section St
Mount Vernon, WA 98274
Phone (360) 424-3952

6406 Marine Dr
Ste A
Tulalip, WA 98271

7520 Totem Beach Rd
Tulalip, WA 98271
Phone (360) 651-4511

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1851882146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 E SECTION ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982749124",
            "telephone_number": "360-428-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 E SECTION ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982749124",
            "telephone_number": "360-428-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "KHOA",
        "middle_name": "DINH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "58.030435",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61215451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.