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MR. KEVIN DATHIEN NGUYEN PA-C
NPI 1902420912
Physician Assistant in Pomona, CA

Active since June 05, 2020PECOS EnrolledAccepts Medicare Assignment
1501 E HOLT AVE # A, POMONA, CA 91767(909) 623-3600 Get Directions Write a Review

NPPES record last updated: April 26, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 26, 2021, Aug 24, 2020, Jun 5, 2020 (3 updates tracked since 2020).

About Mr. Kevin Dathien Nguyen Pa-c NPPES

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

MR. KEVIN DATHIEN NGUYEN PA-C (NPI 1902420912) is an individual physician assistant in Pomona, California, licensed in California (58123) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1902420912
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. KEVIN DATHIEN NGUYENCredential: PA-C
Location Address1501 E HOLT AVE # APomona, CA 91767-5823
Mailing Address1501 E Holt Ave, Ste APomona, CA 91767-5823 · (909) 988-2555 · Fax (909) 460-6600
Phone(909) 623-3600
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 5, 2020
Last NPPES UpdateApril 26, 20213 updates tracked since enumeration
NPPES CertifiedApril 26, 2021
✔ NPI 1902420912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 58123
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1501 E HOLT AVE # A, Pomona, CA 91767
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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

Mr. Kevin Dathien Nguyen Pa-c 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 ID9133546757
PECOS Enrollment IDI20200827002793
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
33 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91767 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Nguyen's NPI number?

The NPI number for Kevin Nguyen is 1902420912. It was assigned to this individual provider in the NPPES registry on June 5, 2020.

Where is Kevin Nguyen located?

Kevin Nguyen practices at 1501 E Holt Ave # A, Pomona, CA 91767. The listed phone number is (909) 623-3600.

What is Kevin Nguyen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kevin Nguyen enrolled in Medicare?

Yes. Kevin Nguyen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kevin Nguyen was last updated on April 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.