Individual provider Active NPI

Thao Thanh Nguyen Rodriguez, APRN

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1922463835
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95011546 Issued in CA
Practice address
300 UCLA Medical PLZ Ste B200
Los Angeles, CA 90095-1106
Phone
(310) 794-1195
NPI assigned
Dec 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 6764 CT
Nurse Practitioner 363L00000X 95011546 CA Primary

Addresses

Primary practice location

300 UCLA Medical PLZ Ste B200
Los Angeles, CA 90095-1106

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Other practice location 1

874 Howard Ave
Basement - Room 007
New Haven, CT 06519-1106
Phone (203) 688-8200

Other identifiers 6

IdentifierTypeStateIssuer
1922463835MedicaidCT
AA533035OtherCTHARVARD PILGRIM
1922463835OtherCTANTHEM
3093495OtherCTCIGNA
4841947OtherCTAETNA
1922463835OtherCTMULTIPLAN

Other names 1

  • Thao Nguyen Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Thao.Rodriguez@med.usc.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170120000149 CT Practitioner - Nurse Practitioner 7618256074 Reassigns benefits to 1 organization
I20220803000734 CA Practitioner - Nurse Practitioner 7618256074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Johns Hopkins University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Medical PLZ
Suite 425
Los Angeles, CA 90095-0001
Phone (310) 794-1500

150 Medical PLZ
Los Angeles, CA 90095-0001
Phone (310) 825-9989

200 UCLA Medical PLZ
Suite 120
Los Angeles, CA 90095-0001
Phone (310) 206-6931

300 Medical Plaza
B200
Los Angeles, CA 90095-0001
Phone (310) 794-1195

300 Medical PLZ
Los Angeles, CA 90095-0001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.73 of 100Reported as group
Quality
86.41
Promoting interoperability
100
Improvement activities
40
Cost
67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95011546CAMDNurse Practitioner
6764CTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Sep 1, 2022 Accepting new patients
The Regents of the University of California CurrentSince Sep 1, 2022 Accepting new patients
Northeast Medical Group, Inc. Nurse Practitioner CurrentSince Jan 1, 2017 Accepting new patients
Yale New Haven Hospital Past Accepting new patients

Locations

300 Medical Plz
Ste B200
Los Angeles, CA 90095
Phone (310) 794-1459

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

300 UCLA Medical Plz
Ste B200
Los Angeles, CA 90095
Phone (310) 825-4989

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

874 Howard Ave
Bsmt
New Haven, CT 06519
Phone (203) 688-8200

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: trodriguez988785@direct.uclahealth.org
  • Direct secure messaging: thao.rodriguez@med.usc.edu

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": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1922463835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UCLA MEDICAL PLZ STE B200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951106",
            "telephone_number": "310-794-1195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "874 Howard Ave",
            "address_2": "Basement - Room 007",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065191106",
            "country_code": "US",
            "telephone_number": "203-688-8200",
            "fax_number": "203-688-8204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "THAO",
        "middle_name": "THANH NGUYEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "6764",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95011546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922463835",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA533035",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1922463835",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3093495",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4841947",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "1922463835",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Thao.Rodriguez@med.usc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1441 Eastlake Ave # G419",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900891019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THAO",
            "last_name": "NGUYEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.