Active NPI
Thuytrang Diep Nguyen, M.D.
- Internal Medicine Physician
- San Juan Capistrano, CA
National Provider Identifier
1861537656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A61868
- Practice address
- 30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304 - Phone
- (949) 240-2030
- Fax
- (949) 240-5869
- NPI assigned
- Feb 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A61868 | CA | Primary |
Addresses
Primary practice location
30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304
Mailing address
30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304
Phone (949) 240-2030
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A618680B12 | Other | CA | CALOPTIMA |
| 00A618680 | Other | CA | MEDICAL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61868 | CA | MD | Prosthodontist |
| A61868 | CA | MD | Internal Medicine Physician |
Practice roles (3 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- thuytrangdiepnguyen@chcca.allscriptsdirect.net
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Community Health Clinic/Center
- San Juan Capistrano, CA
- NPI 1366560393
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Anaheim, CA
- NPI 1952333460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1861537656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30300 CAMINO CAPISTRANO",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926751304",
"telephone_number": "949-240-2030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30300 CAMINO CAPISTRANO",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926751304",
"telephone_number": "949-240-2030",
"fax_number": "949-240-5869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "THUYTRANG",
"middle_name": "DIEP",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2021-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A61868",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALOPTIMA",
"identifier": "A618680B12",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "00A618680",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "441 N Lakeview Ave",
"city": "Anaheim",
"state": "CA",
"country_code": "US",
"postal_code": "928073028",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in San Juan Capistrano, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.