KHANH QUOC NGUYEN (N.P) – Nurse Practitioner, NPI 1073536595

KHANH QUOC NGUYEN (N.P) is a healthcare provider. based in Stockton, California. specializing in NURSE PRACTITIONER. They hold the professional credentials N.P. They hold a License No. 13374 (CA). The NPI Number for KHANH QUOC NGUYEN (N.P) is 1073536595

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
KHANH QUOC NGUYEN (N.P)
NPI
1073536595
Phone
(209) 954-3100
Address
1801 E MARCH LN
Enumeration Date
25 July 2006
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9169735499
Graduation Year
2002 (24 years ago)
PAC ID
3173653904
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20100604000794
Address ID
CA958252135SA2016XAVEX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

16,360 NURSE PRACTITIONER in CA

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Provider Addresses for KHANH QUOC NGUYEN (N.P)

  • 1801, East March Lane, Akers, Stockton, San Joaquin County, California, 95210, United States

    STOCKTON, CA 952106629

    Phone: (209) 954-3100

    Type: Location

  • 10609, Willow Glen Circle, Stockton, San Joaquin County, California, 95209, United States

    STOCKTON, CA 952094195

    Phone: (209) 957-5083

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $34.

Total Amount is formed as General ($34) + Research ($0) + Ownership ($0) = $34.

Last reported payment date: 2024-04-19 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($17).

Total Amount

$34

General + Research + Ownership

Payments

2

Total payment records

General Amount

$34

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-19

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: 2010-06-04

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
I20100604000794INurse PractitionerCATBD

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 95210)

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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: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
Colorectal Surgery (Proctology), General SurgeryLA
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Emergency MedicineCA
-MA
Emergency MedicineCA

Reviews

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Frequently asked questions

Does KHANH QUOC NGUYEN (N.P) have a public NPI I can cite?
Public records show KHANH QUOC NGUYEN (N.P) under NPI 1073536595.
Is KHANH QUOC NGUYEN (N.P)'s NPI status active today?
Active status means KHANH QUOC NGUYEN (N.P)'s NPI record is not deactivated in the public file.
What type of care does KHANH QUOC NGUYEN (N.P) provide?
KHANH QUOC NGUYEN (N.P)'s profile centers on Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Can patients visit KHANH QUOC NGUYEN (N.P) in Stockton, California?
For routing, start with Stockton, California for KHANH QUOC NGUYEN (N.P), then verify phone and hours locally.
Can I export KHANH QUOC NGUYEN (N.P)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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