Individual provider Active NPI

Vanly Nguyen, MD

  • Obstetrics & Gynecology Physician
  • Kirkland, WA
National Provider Identifier
1871828855
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
56629-20 Issued in WI
Practice address
12910 Totem Lake Blvd NE Ste 102
Kirkland, WA 98034-2901
Phone
(425) 899-4455
Fax
(425) 899-4434
NPI assigned
Oct 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 60852394 WA
Obstetrics & Gynecology Physician 207V00000X 56629-20 WI Primary

Addresses

Primary practice location

12910 Totem Lake Blvd NE Ste 102
Kirkland, WA 98034-2901

Mailing address

6235 127TH Ave SE
Bellevue, WA 98006-3942
Phone (856) 291-1590

Other practice location 1

12040 NE 128th St
Kirkland, WA 98034-3013
Phone (425) 899-1000

Other practice location 2

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-4101

Other identifiers 1

IdentifierTypeStateIssuer
1871828855MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20181218003037 WA Practitioner - Obstetrics/Gynecology 2365636719 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Arkansas College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unified Center for Women'S Health, PLLCGroup PAC ID 7911212824, 13 clinicians
Obhg Washington PCGroup PAC ID 0345364642, 44 clinicians

Practice addresses (Care Compare)

12910 Totem Lake Blvd NE
Suite 102
Kirkland, WA 98034-2901
Phone (425) 899-4455

1717 J St
Tacoma, WA 98405-4933
Phone (864) 908-3530

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60852394WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Oct 31, 2018 Accepting new patients
King County Public Hospital District No 2 CurrentSince Oct 31, 2018 Accepting new patients
Obhg Washington, PC Obstetrics & Gynecology CurrentSince Sep 11, 2018 Accepting new patients
King County Public Hospital District No. 2 Past Accepting new patients

Locations

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

1717 S J St
Stop 101
Tacoma, WA 98405

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Organizations & group practices 6

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": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1871828855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6235 127TH AVE SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980063942",
            "telephone_number": "856-291-1590",
            "fax_number": "920-206-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12910 TOTEM LAKE BLVD NE STE 102",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342901",
            "telephone_number": "425-899-4455",
            "fax_number": "425-899-4434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12040 NE 128th St",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980343013",
            "country_code": "US",
            "telephone_number": "425-899-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1717 S J St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054933",
            "country_code": "US",
            "telephone_number": "253-426-4101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VANLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-09",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "60852394",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "56629-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871828855",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.