Organization Active NPI

Quan a Nguyen, DO PA

  • Internal Medicine Physician
  • Altamonte Springs, FL
National Provider Identifier
1922240597
Registry record updated Nov 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS9247 Issued in FL
Legal business name
QUAN A NGUYEN, DO PA
Practice address
350 Maitland Ave
Ste 1001
Altamonte Springs, FL 32701
Phone
(407) 339-7682
Fax
(407) 339-7690
NPI assigned
Mar 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2022

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

Authorized official

Name
Dr. Quan Anh Nguyen, D.O.NPI 1922069533
Title
President
Phone
(407) 339-7682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X OS9247 FL Primary

Addresses

Primary practice location

350 Maitland Ave
Ste 1001
Altamonte Springs, FL 32701

Mailing address

350 Maitland Ave
Ste 1001
Altamonte Springs, FL 32701-5400
Phone (407) 339-7682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100209000715 FL Part B Supplier - Clinic/Group Practice 6800939018 Receives reassigned benefits from 1 practitioner
Practice locations: Altamonte Springs, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2001364Quan a Nguyen DO PA350 Maitland Ave Ste 1001, Altamonte Springs, FL 32701Certificate of waiverDec 16, 2027

National Provider Directory

National Provider Directory

Locations

350 Maitland Ave
Ste 1001
Altamonte Springs, FL 32701
Phone (407) 339-7682

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1238284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668297600000",
    "number": "1922240597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 MAITLAND AVE",
            "address_2": "STE 1001",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015400",
            "telephone_number": "407-339-7682",
            "fax_number": "407-339-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MAITLAND AVE",
            "address_2": "STE 1001",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "32701",
            "telephone_number": "407-339-7682",
            "fax_number": "407-339-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAN A NGUYEN, DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-29",
        "last_updated": "2022-11-13",
        "certification_date": "2022-11-13",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "QUAN",
        "authorized_official_middle_name": "ANH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-339-7682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS9247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.