DR. KIM NGOC NGUYEN (MD) – Family Medicine Physician, NPI 1053013771

DR. KIM NGOC NGUYEN (MD) is a healthcare provider. based in Fountain valley, California. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. A205793 (CA). The NPI Number for DR. KIM NGOC NGUYEN (MD) is 1053013771

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
DR. KIM NGOC NGUYEN (MD)
NPI
1053013771
Phone
(714) 598-5810
Address
16444 EVEREST CIR
Enumeration Date
17 March 2023
Last Update Date
22 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7148992000
Graduation Year
2023 (3 years ago)
PAC ID
5597060939
Group Practice PAC ID
2466687728
Professional Enrollment ID
I20250502003047
Address ID
CA928442751GA9191XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:3State licenses:1Digital endpointsOther names

13,194 FAMILY PRACTICE in CA

Provider Addresses for DR. KIM NGOC NGUYEN (MD)

  • 16444 EVEREST CIR

    FOUNTAIN VALLEY, CA 927081849

    Phone: (714) 598-5810

    Type: Mailing

  • 5451 WALNUT AVE

    CHINO, CA 917102609

    Phone: (094) 648-6009

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $31.

Total Amount is formed as General ($31) + Research ($0) + Ownership ($0) = $31.

Last reported payment date: 2024-11-22 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($31).

Total Amount

$31

General + Research + Ownership

Payments

1

Total payment records

General Amount

$31

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250502003047IFamily PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92708)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466687728View full group profile
NameSpecialtyState
Nurse PractitionerCA
Family PracticeCA
Osteopathic Manipulative MedicineCA
Internal MedicineCA
Physician AssistantCA
Internal MedicineCA
-CA
-CA
Family PracticeCA

Reviews

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Frequently asked questions

What number should I use to identify DR. KIM NGOC NGUYEN (MD) for billing?
Administrative and clinical systems typically use NPI 1053013771 for DR. KIM NGOC NGUYEN (MD).
Quick check: is DR. KIM NGOC NGUYEN (MD) active?
Public NPPES data shows DR. KIM NGOC NGUYEN (MD) with an active NPI status right now.
Which specialty label fits DR. KIM NGOC NGUYEN (MD)?
NPPES ties DR. KIM NGOC NGUYEN (MD) to Family Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. KIM NGOC NGUYEN (MD)?
DR. KIM NGOC NGUYEN (MD) is associated with Fountain Valley, California in the same public data insurers reference.
Who maintains DR. KIM NGOC NGUYEN (MD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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