Individual provider Active NPI

Kim Nguyen

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1962823989
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5440 Harvest Hill Rd Ste 182B
Dallas, TX 75230-1607
Phone
(214) 348-7611
Fax
(214) 348-0129
NPI assigned
Dec 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5440 Harvest Hill Rd Ste 182B
Dallas, TX 75230-1607

Mailing address

1901 N Macarthur Blvd
Emergency Department
Irving, TX 75061-2220
Phone (214) 499-0203

Other practice location 1

1901 N MacArthur Blvd
Emergency Department
Irving, TX 75061-2220
Phone (214) 499-0203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140222000124 TX Practitioner - Physician Assistant 8921238726 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. David'S Carenow Urgent Care PLLC Past Accepting new patients

Organizations & group practices 5

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": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1962823989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N MACARTHUR BLVD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750612220",
            "telephone_number": "214-499-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 HARVEST HILL RD STE 182B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301607",
            "telephone_number": "214-348-7611",
            "fax_number": "214-348-0129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 N MacArthur Blvd",
            "address_2": "Emergency Department",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750612220",
            "country_code": "US",
            "telephone_number": "214-499-0203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.