Individual provider Active NPI

Diana Ngoc Nguyen, PA-C

  • Medical Physician Assistant
  • San Jose, CA
National Provider Identifier
1861834400
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA23066 Issued in CA
Practice address
667 N White Rd
San Jose, CA 95127-1447
Phone
(408) 646-8590
NPI assigned
Jul 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA23066 CA Primary

Addresses

Primary practice location

667 N White Rd
San Jose, CA 95127-1447

Mailing address

667 N White Rd
San Jose, CA 95127-1447
Phone (408) 646-8590

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140123000040 CA Practitioner - Physician Assistant 0042448904 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA23066CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Jun 28, 2015 Accepting new patients
Cep America - California CurrentSince Sep 1, 2015 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

2425 Samaritan Dr
San Jose, CA 95124
Phone (408) 354-2114

Interoperability endpoints

  • Direct secure messaging: dnguyen73002@direct-ucsfmedicalcenter.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1861834400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 N WHITE RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951271447",
            "telephone_number": "408-646-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 N WHITE RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951271447",
            "telephone_number": "408-646-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DIANA",
        "middle_name": "NGOC",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA23066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.