DR. MIMI NGOC NGUYEN (M.D.) – Family Medicine Physician, NPI 1063754075
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
Provider Addresses for DR. MIMI NGOC NGUYEN (M.D.)
1401 Madison St
Ste. 100
Seattle, WA 981041316
Phone: (206) 386-6197
Type: Location
1200 12th Ave S
Seattle, WA 981442712
Phone: (206) 326-2400
Fax: (206) 621-4434
Type: Location
125 16th Ave E
Seattle, WA 981125211
Phone: (206) 326-3000
Fax: (877) 515-2975
Type: Location
955 POWELL AVE SW
RENTON, WA 980572908
Phone: (425) 277-1311
Type: Mailing
4040 S 188TH ST STE 201
SEATAC, WA 981885070
Phone: (425) 277-7200
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 $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2023-03-06 • Largest payer in this snapshot: Axonics, Inc. ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axonics, Inc. | $20 |
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: 2016-08-31
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 |
|---|---|---|---|---|
| I20160831000339 | I | Family Practice | WA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 120 | 78 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 43 | 33 | $0 |
Insurance plans in this area (ZIP 98104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MA | |
| Internal Medicine | VA | |
| Family Practice | GA | |
| Orthopedic Surgery | IL | |
| - | NC | |
| - | TX | |
| Internal Medicine | MA | |
| Family Practice | OR | |
| Nurse Practitioner | WA | |
| Internal Medicine | MA |
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