Individual provider Active NPI

Tri Thuong Nguyen, M.D.

  • Cardiovascular Disease Physician
  • San Diego, CA
National Provider Identifier
1962598425
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G79496 Issued in CA
Practice address
4344 Convoy St. Ste T .
San Diego, CA 92111-3737
Phone
(858) 277-5463
Fax
(858) 279-8296
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G79496 CA Primary

Addresses

Primary practice location

4344 Convoy St. Ste T .
San Diego, CA 92111-3737

Mailing address

4344 Convoy St. Ste T .
San Diego, CA 92111-3737
Phone (858) 277-5463

Other identifiers 1

IdentifierTypeStateIssuer
00G794960MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050421001209 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Peripheral Vascular Disease 6507804317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Peripheral Vascular Disease
Education
Stanford University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri Thuong Nguyen MD ApcGroup PAC ID 9638508815, 6 clinicians

Practice addresses (Care Compare)

7345 Linda Vista Rd
Suite a
San Diego, CA 92111-5800
Phone (858) 277-5463

Hospital & facility affiliations

  • Modern Home Health Care Inc Home health agency, Chula Vista, CA, CCN 059391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tri Thuong Nguyen MD Apc CurrentSince Feb 17, 2020 Accepting new patients
Scripps Health Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

4551 El Cajon Blvd
San Diego, CA 92115
Phone (619) 280-7185

7345 Linda Vista Rd
Ste A
San Diego, CA 92111
Phone (858) 277-5463

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962598425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4344 CONVOY ST. STE T .",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113737",
            "telephone_number": "858-277-5463",
            "fax_number": "858-279-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4344 CONVOY ST. STE T .",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113737",
            "telephone_number": "858-277-5463",
            "fax_number": "858-279-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRI",
        "middle_name": "THUONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G79496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G794960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.