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Martin Tai Nguyen

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1747 E Morten Ave Ste 303, Phoenix, AZ 85020-7625

PECOS Enrollment

This provider is enrolled in PECOS as MARTIN NGUYEN.

Based on the most recent information from CMS, provider Martin Tai Nguyen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1396330825
Provider Type
Individual
Full Name
Nguyen, Martin Tai
Title
Mr.
Credential
PA

Gender
Male
Sole Proprietor
Yes
Enumeration Date
3/6/2021
Last Updated
10/7/2021

Contact Information

Practice Location

1747 E Morten Ave Ste 303, Phoenix, AZ 85020-7625

(602) 589-0370

(602) 589-0650

Mailing Location

3118 W Thomas Rd Ste 713, Phoenix, AZ 85017-5308

(602) 456-2821

(602) 347-6272

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Martin Tai Nguyen

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Rivera, Lisa Marie

Amanda Matje Pa-C Pllc

Langford, Sydney Jane

Dorn, Blair

Migdal, Talor

Healing Hands Family Practice And Aesthetics Corp

Cinalli, Maria Veronica

Vacco, Alaina Anne

Underwood, Kooper Harrison