Individual provider Active NPI

Thien Minh Nguyen, MD

  • Emergency Medicine Physician
  • Riverside, CA
National Provider Identifier
1992383152
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A192561 Issued in CA
Practice address
4445 Magnolia Ave
Riverside, CA 92501-4199
Phone
(951) 809-2738
NPI assigned
Mar 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A192561 CA Primary

Addresses

Primary practice location

4445 Magnolia Ave
Riverside, CA 92501-4199

Mailing address

4510 Brockton Ave
Riverside, CA 92501-4015
Phone (951) 809-2738

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

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
I20240806004536 CA Practitioner - Emergency Medicine 4688111727 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Boston University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Jude Emergency Medical Group IncGroup PAC ID 8224923479, 20 clinicians

Practice addresses (Care Compare)

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone (714) 871-3280

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
  • Chapman Global Medical Center Hospital, Orange, CA, CCN 050745

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A192561CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Jude Emergency Medical Group Inc Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Memorialcare Medical Foundation Family Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

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 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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1992383152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014015",
            "telephone_number": "951-809-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014199",
            "telephone_number": "951-809-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THIEN",
        "middle_name": "MINH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A192561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.