Active NPI
An Nguyen, DO
- Family Medicine Physician
- Camas, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 16877
- Practice address
- 4500 SE Columbia Palisades Drive
Camas, WA 98607 - Phone
- (360) 882-2778
- Fax
- (360) 604-1772
- NPI assigned
- Mar 23, 2017
- Last updated
- Aug 24, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 16877 | CA | Primary |
Addresses
Primary practice location
4500 SE Columbia Palisades Drive
Camas, WA 98607
Mailing address
700 NE 87TH Ave
Vancouver, WA 98664-4896
Phone (360) 882-2778
Other practice location 1
501 SE 172nd Ave Ste 130
Vancouver, WA 98684-9542
Phone (360) 882-2778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2162282 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- 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
- Family Practice
- Education
- Touro Un Col of Osteopathic Medicine, Henderson, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4500 SE Columbia Palisades Dr
Camas, WA 98607-8444
Phone (360) 882-2778
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| The Vancouver Clinic Inc PS | Family Medicine | Current | Accepting new patients |
| Community Foundation Medical Group | Past | Accepting new patients |
Locations
4500 SE Columbia Palisades Dr
Camas, WA 98607
501 SE 172nd Ave
Vancouver, WA 98684
501 SE 172nd Ave
Ste 130
Vancouver, WA 98684
700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500
Interoperability endpoints
- anguyen16729@tvc-direct.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba The Vancouver Clinic
- Internal Medicine Physician
- Vancouver, WA
- NPI 1992759427
Family Medicine
-
dba Salmon Creek 2 Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Vancouver, WA
- NPI 1306556907
-
dba Sante' Foundation Medical Group
- Internal Medicine Physician
- Fresno, CA
- NPI 1811258510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598227200000",
"number": "1952832651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 NE 87TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986644896",
"telephone_number": "360-882-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 SE COLUMBIA PALISADES DRIVE",
"city": "CAMAS",
"state": "WA",
"postal_code": "98607",
"telephone_number": "360-882-2778",
"fax_number": "360-604-1772"
}
],
"practiceLocations": [
{
"address_1": "501 SE 172nd Ave Ste 130",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986849542",
"country_code": "US",
"telephone_number": "360-882-2778",
"fax_number": "360-604-1772",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "AN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-23",
"last_updated": "2020-08-24",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "16877",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2162282",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Camas, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.