KHOA BA NGUYEN – Dermatology Physician, NPI 1073139630
Dermatology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
2,140 DERMATOLOGY in CA
Provider Addresses for KHOA BA NGUYEN
100 W California Blvd
Pasadena, CA 911053010
Phone: (714) 931-1440
Type: Location
100 W CALIFORNIA BLVD
PASADENA, CA 911053010
Phone:
Type: Mailing
5767 W CENTURY BLVD STE 400
LOS ANGELES, CA 900455631
Phone: (310) 301-8707
Type: Mailing
2020 SANTA MONICA BLVD STE 510
SANTA MONICA, CA 904042131
Phone: (310) 917-3376
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $266.
Total Amount is formed as General ($266) + Research ($0) + Ownership ($0) = $266.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Dermavant Sciences, Inc. ($129).
Total Amount
$266
General + Research + Ownership
Payments
3
Total payment records
General Amount
$266
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dermavant Sciences, Inc. | $129 |
| GENZYME CORPORATION | $122 |
| Galderma Laboratories, L.P. | $15 |
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: 2023-11-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231109002962 | I | Dermatology | CA | TBD |
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.
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 91105)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| - | CA | |
| - | CA | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| D E R M A T O L O G Y | CA | |
| - | CA |
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