KOLBY VAN NGUYEN
NPI 1104707595
Anesthesiologist Assistant in Pembroke Pines, FL

Q: What is Kolby Nguyen's NPI number?

The NPI number for Kolby Nguyen is 1104707595. It was assigned to this individual provider in the NPPES registry on September 11, 2025.

Q: What is Kolby Nguyen's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Kolby Nguyen was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 11, 2025Accepts Medicare Assignment

7800 SHERIDAN ST, PEMBROKE PINES, FL 33024(954) 939-5000 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kolby Van Nguyen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOLBY VAN NGUYEN (NPI 1104707595) is an individual anesthesiologist assistant in Pembroke Pines, Florida and active in the NPI registry since September 2025. He is affiliated with Memorial Hospital Pembroke and is a graduate of Other (2022).

NPPES Registry Identity

NPI1104707595

Entity TypeIndividualMale

Primary Taxonomy367H00000X

Provider Legal NameKOLBY VAN NGUYEN

Location Address7800 SHERIDAN STPembroke Pines, FL 33024-2536

Mailing Address9520 Seagrape Dr Apt 201Davie, FL 33324-5921

Phone(954) 939-5000

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateSeptember 11, 2025

NPPES CertifiedSeptember 10, 2025

✔ NPI 1104707595 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

7800 SHERIDAN ST, Pembroke Pines, FL 33024

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kolby Van Nguyen is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860998374

PECOS Enrollment IDI20251003000293

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital Pembroke

Acute Care Hospitals · Pembroke Pines, FL

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100230

Location7800 Sheridan StPembroke Pines, FL 33024 · Broward County

Emergency services

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MANUEL EGUED III

Internal Medicine