Individual provider Active NPI

Kim-Phung Thi Nguyen, M.D.

  • Colon & Rectal Surgery Physician
  • Tampa, FL
National Provider Identifier
1982990065
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
ME127435 Issued in FL
Practice address
3000 Medical Park Dr Ste 500
Tampa, FL 33613-6600
Phone
(813) 615-7030
Fax
(813) 615-8350
NPI assigned
Jun 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2011016860 MO
Student in an Organized Health Care Education/Training Program 390200000X ME127435 FL
Colon & Rectal Surgery Physician 208C00000X ME127435 FL Primary

Addresses

Primary practice location

3000 Medical Park Dr Ste 500
Tampa, FL 33613-6600

Mailing address

3000 Medical Park Dr Ste 500
Tampa, FL 33613-6600
Phone (813) 615-7030

Other practice location 1

4814 N Habana Ave
Tampa, FL 33614-6871
Phone (813) 543-2650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220706003656 FL Practitioner - Colorectal Surgery (Proctology) 6709188139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

3000 Medical Park Dr
Suite 500
Tampa, FL 33613-6600
Phone (813) 615-7007

Hospital & facility affiliations

  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy15
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc CurrentSince Jun 20, 2022 Accepting new patients

Locations

116 Parsons Park Dr
Brandon, FL 33511
Phone (813) 681-6625

3000 Medical Park Dr
Ste 500
Tampa, FL 33613
Phone (813) 615-7028

4814 N Habana Ave
Tampa, FL 33614
Phone (813) 873-2650

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: knguyen630268@adventhealth.direct-ci.com

Organizations & group practices 1

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 3

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1982990065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR STE 500",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336136600",
            "telephone_number": "813-615-7030",
            "fax_number": "813-615-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL PARK DR STE 500",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336136600",
            "telephone_number": "813-615-7030",
            "fax_number": "813-615-8350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4814 N Habana Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336146871",
            "country_code": "US",
            "telephone_number": "813-543-2650",
            "fax_number": "813-873-2690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM-PHUNG",
        "middle_name": "THI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2011016860",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "ME127435",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME127435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.