Individual provider Active NPI

Ronald Tyson Nguyen, DO

  • Emergency Medicine Physician
  • Bronx, NY
National Provider Identifier
1912409509
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A22507 Issued in CA
Practice address
4422 3Rd Ave
Bronx, NY 10457-2594
Phone
(718) 960-9000
NPI assigned
Feb 28, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A22507 CA Primary

Addresses

Primary practice location

4422 3Rd Ave
Bronx, NY 10457-2594

Mailing address

4422 3Rd Ave
Bronx, NY 10457-2594
Phone (718) 960-9000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240826002505 CA Practitioner - Emergency Medicine 0042759714 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians
Pacific Coast Emergency Medical Associates, IncGroup PAC ID 5092861054, 12 clinicians

Practice addresses (Care Compare)

12601 Garden Grove Blvd
Garden Grove, CA 92843-1908
Phone (714) 537-5160

2776 Pacific Ave
Long Beach, CA 90806-2613
Phone (562) 997-2290

Hospital & facility affiliations

  • Centinela Hospital Medical Center Hospital, Inglewood, CA, CCN 050739
  • College Medical Center Hospital, Long Beach, CA, CCN 050776
  • Garden Grove Hospital & Medical Center Hospital, Garden Grove, CA, CCN 050230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A22507CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Emergency Medical Associates, Inc Emergency Medicine CurrentSince Jul 15, 2024 Accepting new patients
Centinela Freeman Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Jul 15, 2024 Accepting new patients
Western University of Health Sciences PastSince Dec 1, 2019 Accepting new patients

Locations

555 E Hardy St
Inglewood, CA 90301
Phone (310) 419-8636

2776 Pacific Ave
Long Beach, CA 90806
Phone (562) 595-1911

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.

Hospital & facility affiliations 3

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1912409509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572594",
            "telephone_number": "718-960-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572594",
            "telephone_number": "718-960-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "RONALD",
        "middle_name": "TYSON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-28",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A22507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.