Active NPI
Monica Oviedo, PA
- Medical Physician Assistant
- Lynwood, CA
National Provider Identifier
1003974643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA16294
- Practice address
- 3630 East Imperial Hwy
Lynwood, CA 90262-2678 - Phone
- (310) 900-8900
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA16294 | CA | Primary |
Addresses
Primary practice location
3630 East Imperial Hwy
Lynwood, CA 90262-2678
Mailing address
PO Box 12110
Westminster, CA 92685-2110
Phone (562) 809-3571
Other practice location 1
2501 E Chapman Ave Ste 101
Orange, CA 92869-3204
Phone (714) 633-1011
Other practice location 2
2251 N Harbor Blvd
Fullerton, CA 92835-2601
Phone (714) 449-6230
Other practice location 3
2212 E 4th St
Santa Ana, CA 92705-3870
Phone (714) 633-1011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA16294 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070223000429 | CA | Practitioner - Physician Assistant | 3870695786 | Reassigns benefits to 3 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Front Line Emergency Care Spec | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Riverside, CA
- NPI 1972539039
CA
-
- Emergency Medicine Physician
- Lynwood, CA
- NPI 1366451080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582675200000",
"number": "1003974643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12110",
"city": "WESTMINSTER",
"state": "CA",
"postal_code": "926852110",
"telephone_number": "562-809-3571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3630 EAST IMPERIAL HWY",
"city": "LYNWOOD",
"state": "CA",
"postal_code": "902622678",
"telephone_number": "310-900-8900"
}
],
"practiceLocations": [
{
"address_1": "2501 E Chapman Ave Ste 101",
"address_purpose": "LOCATION",
"city": "Orange",
"state": "CA",
"postal_code": "928693204",
"country_code": "US",
"telephone_number": "714-633-1011",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2251 N Harbor Blvd",
"address_purpose": "LOCATION",
"city": "Fullerton",
"state": "CA",
"postal_code": "928352601",
"country_code": "US",
"telephone_number": "714-449-6230",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2212 E 4th St",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927053870",
"country_code": "US",
"telephone_number": "714-633-1011",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OVIEDO",
"first_name": "MONICA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2020-02-26",
"certification_date": "2020-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA16294",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PA16294",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynwood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.