Active NPI
Tiffany Bao Tran Nguyen, DO
- Student in an Organized Health Care Education/Training Program
- Staten Island, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 355 Bard Avenue
Department of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310 - Phone
- (718) 818-2419
- NPI assigned
- May 11, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
355 Bard Avenue
Department of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310
Mailing address
355 Bard Avenue Dept. of Medicine Villa BLDG 1St Floor
Staten Island, NY 10310
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Touro Un College of Osteopathic Medicine, Vallejo, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A22307 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Permanente Medical Group, Inc | Current | Accepting new patients |
Locations
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738
900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014
1800 Harrison St
Fl 7
Oakland, CA 94612
101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
930 W Main St
Ripon, CA 95366
Phone (209) 599-4221
501 J St
Sacramento, CA 95814
Phone (916) 497-3000
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
700 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 851-5300
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Santa Clara, CA
- NPI 1073606299
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1841373800
-
- Clinical Medical Laboratory
- San Jose, CA
- NPI 1497971584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701993600000",
"number": "1942822176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 BARD AVENUE DEPT. OF MEDICINE VILLA BLDG 1ST FLOOR",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 BARD AVENUE",
"address_2": "DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10310",
"telephone_number": "718-818-2419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "TIFFANY",
"middle_name": "BAO TRAN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-11",
"last_updated": "2023-12-08",
"certification_date": "2023-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "700 Lawrence Expy",
"city": "Santa Clara",
"state": "CA",
"country_code": "US",
"postal_code": "950515173",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.