Individual provider Active NPI

Jennifer Nguyen, DO

  • Family Medicine Physician
  • Lake Worth, TX
National Provider Identifier
1871860700
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P1794 Issued in TX
Practice address
3914 Telephone Rd
Lake Worth, TX 76135-2908
Phone
(817) 238-0109
Fax
(817) 238-0647
NPI assigned
Nov 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P1794 TX Primary

Addresses

Primary practice location

3914 Telephone Rd
Lake Worth, TX 76135-2908

Mailing address

3914 Telephone Rd
Lake Worth, TX 76135-2908
Phone (817) 238-0109

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
I20120829000807 TX Practitioner - Family Practice 5395992150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3914 Telephone Rd
Lake Worth, TX 76135-2908
Phone (817) 238-0109

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P1794TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas PLLC CurrentSince Sep 4, 2012 Accepting new patients
Medical Clinic of North Texas, PLLC Family Medicine Current Accepting new patients
Medical Clinic of North Texas, PLLC Family Medicine CurrentSince Sep 4, 2012 Accepting new patients

Locations

809 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 277-7133

900 Airport Fwy
Ste 158
Hurst, TX 76054
Phone (817) 514-4000

3914 Telephone Rd
Lake Worth, TX 76135
Phone (817) 238-0109

4001 W 15th St
Ste 245
Plano, TX 75093
Phone (972) 596-5222

Interoperability endpoints

  • Direct secure messaging: jennifer.nguyen@wellmed.eclinicaldirectplus.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1871860700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 TELEPHONE RD",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761352908",
            "telephone_number": "817-238-0109",
            "fax_number": "817-238-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3914 TELEPHONE RD",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761352908",
            "telephone_number": "817-238-0109",
            "fax_number": "817-238-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JENNIFER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P1794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, TX

Sources for this page

Verify at the official NPI Registry.