Individual provider Active NPI

Paul Nguyen

  • Physical Therapist
  • Menlo Park, CA
National Provider Identifier
1942645809
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39880 Issued in CA
Practice address
68 Willow Rd
Menlo Park, CA 94025-3653
Phone
(877) 390-6659
Fax
(916) 913-5646
NPI assigned
May 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 39880 CA Primary

Addresses

Primary practice location

68 Willow Rd
Menlo Park, CA 94025-3653

Mailing address

PO Box 70661
Richmond, CA 94807-0661

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190220003345 CA Practitioner - Physical Therapist in Private Practice 6305184169 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Oct 22, 2018 Accepting new patients
North Carolina Luna Care Physical Therapy LLC Physical Therapist PastSince Apr 6, 2021 Accepting new patients

Locations

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1942645809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70661",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948070661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 WILLOW RD",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940253653",
            "telephone_number": "877-390-6659",
            "fax_number": "916-913-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-06",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.