Individual provider Active NPI

Dai Trang Tunguyen, DPM

  • Podiatrist
  • Elk Grove, CA
National Provider Identifier
1881793420
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4084 Issued in CA
Practice address
8170 Laguna Blvd
#105
Elk Grove, CA 95758-7901
Phone
(916) 691-5945
Fax
(916) 691-5946
NPI assigned
Sep 21, 2006
Reactivated
Oct 18, 2021
Last updated
Oct 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4084 CA Primary

Addresses

Primary practice location

8170 Laguna Blvd
#105
Elk Grove, CA 95758-7901

Mailing address

10470 Old Placerville Rd
#100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other identifiers 1

IdentifierTypeStateIssuer
000E40840MedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090107000414 CA Practitioner - Podiatry 5294898953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue142
Removal or shaving of skin growth73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4084CAMDPodiatrist
4084CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Current Accepting new patients
Dignity Community Care Past Accepting new patients
Sutter Regional Medical Foundation Podiatrist Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: dtunguyendpm58245@hisp.ehr.sutterhealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1881793420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "#100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 LAGUNA BLVD",
            "address_2": "#105",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587901",
            "telephone_number": "916-691-5945",
            "fax_number": "916-691-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNGUYEN",
        "first_name": "DAI TRANG",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "deactivation_date": "2021-09-29",
        "reactivation_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E40840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.