THANH M NGUYEN MD
NPI 1831296656
Pediatrics - Pediatric Endocrinology in Jacksonville, FL

NPI Status: Active since September 20, 2006

Contact Information

12086 FORT CAROLINE RD
STE 401
JACKSONVILLE, FL
ZIP 32225
Phone: (904) 565-1271

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  • Individual
  • Male
  • Years of Experience 24
  • Pediatrics
  • Pediatric Endocrinology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About THANH NGUYEN

This page provides the complete NPI Profile along with additional information for Thanh Nguyen, a pediatrician established in Jacksonville, Florida with a medical specialization in Pediatrics, focusing in pediatric endocrinology and more than 24 years of experience. He graduated from Ohio State University College Of Medicine in 2002. The healthcare provider is registered in the NPI registry with number 1831296656 assigned on September 2006. The practitioner's primary taxonomy code is 2080P0205X with license number ME101652 (FL). The provider is registered as an individual and his NPI record was last updated 11 years ago.

NPI
1831296656
Provider Name
THANH M NGUYEN MD
Gender
Male
Entity Type
Individual
Location Address
12086 FORT CAROLINE RD STE 401 JACKSONVILLE, FL 32225
Location Phone
(904) 565-1271
Mailing Address
PO BOX 3123 ST AUGUSTINE, FL 32085
Mailing Phone
(904) 824-4990
Medical School Name
OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduation Year
2002
Is Sole Proprietor?
No
Enumeration Date
09-20-2006
Last Update Date
11-06-2015
Code Navigator

A pediatrician like Thanh Nguyen is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics Pediatric Endocrinology

Taxonomy Code
2080P0205X
Type
Allopathic & Osteopathic Physicians
License No.
ME101652
License State
FL
Taxonomy Description
A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208000000XAllopathic & Osteopathic Physicians

Pediatrics

ME101652 (FL)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 (Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-05 (Rewards) - POS
  • BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-18 (Rewards) - POS
  • BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Essential- ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Standard - HMO
  • UHC Bronze Standard+ (Dental + Vision) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
  • UHC Gold Standard - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
41503OTHER (01)FLBCBS / FLORIDA BLUE
000031000MEDICAID (05)FL 
DE637YMEDICARE PIN (08)FL 

Medicare Participation & PECOS Enrollment Status

Thanh Nguyen is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Thanh Nguyen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 8921139338

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20100629000659

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    2 DME suppliers used 17 Medicare Claims 17 Services Paid

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $32.51 for a new patient copayment and $24.79 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 32225 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $130.04
  • Minimum New Patient Price $56
  • Maximum New Patient Price $171.84
  • Average New Patient Copayment $32.51
  • Minimum New Patient Copayment $14
  • Maximum New Patient Copayment $42.96

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.16
  • Minimum Established Patient Price $17.57
  • Maximum Established Patient Price $139.16
  • Average Established Patient Copayment $24.79
  • Minimum Established Patient Copayment $4.39
  • Maximum Established Patient Copayment $34.79

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1831296656, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
3
Doubled → 6
Pos 4
1
Unchanged
Pos 5
2
Doubled → 4
Pos 6
9
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
6
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 2 → 4 6 → 12 → 3 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 6 + 1 + 4 + 9 + 1 + 2 + 6 + 1 + 0 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1831296656.

Other Providers at the Same Location


The following 15 providers are registered at the same or a nearby location.

Chiropractor
12086 FORT CAROLINE RD, SUITE 302
JACKSONVILLE, FL 32225
Chiropractor
12086 FORT CAROLINE RD, SUITE 302
JACKSONVILLE, FL 32225
Clinic/Center
12086 FORT CAROLINE RD, UNIT 504
JACKSONVILLE, FL 32225
Chiropractor
12086 FORT CAROLINE RD, SUITE 302
JACKSONVILLE, FL 32225
Chiropractor
12086 FORT CAROLINE RD, SUITE 302
JACKSONVILLE, FL 32225
Dentist (General Practice)
12086 FORT CAROLINE RD, SUITE 105
JACKSONVILLE, FL 32225
Dentist
12086 FORT CAROLINE RD, SUITE 105
JACKSONVILLE, FL 32225
Physician Assistant (Medical)
12086 FORT CAROLINE RD, STE # 401
JACKSONVILLE, FL 32225
Pediatrics
12086 FORT CAROLINE RD, SUITE 401
JACKSONVILLE, FL 32225
Physician Assistant
12086 FORT CAROLINE RD, SUITE #401
JACKSONVILLE, FL 32225
Nurse Practitioner (Pediatrics)
12086 FORT CAROLINE RD, 401
JACKSONVILLE, FL 32225
Family Medicine
12086 FORT CAROLINE RD, STE 401
JACKSONVILLE, FL 32225
Behavior Technician
12086 FORT CAROLINE RD
JACKSONVILLE, FL 32225
Behavior Technician
12086 FORT CAROLINE RD
JACKSONVILLE, FL 32225
Behavior Technician
12086 FORT CAROLINE RD
JACKSONVILLE, FL 32225

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1831296656, enumerated as an "individual" on September 20, 2006.

The provider is located at 12086 FORT CAROLINE RD STE 401 JACKSONVILLE, FL 32225 and the phone number is (904) 565-1271.

Pediatrics with taxonomy code 2080P0205X and a focus in Pediatric Endocrinology.

The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL), Florida. Please consult your insurance carrier or call the provider to verify.