Ryan Van Liew, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA61721 Issued in CA

Practice address

31303 Electric Ave
Nuevo, CA 92567-9110

Phone

(951) 692-9544

NPI assigned

Sep 29, 2022

Sex

Male

Sole proprietor

No

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.

• Em Alliance California, Apc

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1376305755

  CA

  Medicare reassignment
• Inland Valley Trauma and Acute Care Surgery Apc Inc

  • Surgery Physician
  • Wildomar, CA
  • NPI 1417448168

  CA

  Medicare reassignment

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 29, 2022.

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1013631357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31303 ELECTRIC AVE",
            "city": "NUEVO",
            "state": "CA",
            "postal_code": "925679110",
            "telephone_number": "951-692-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31303 ELECTRIC AVE",
            "city": "NUEVO",
            "state": "CA",
            "postal_code": "925679110",
            "telephone_number": "951-692-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN LIEW",
        "first_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA61721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Tejera, LMFT
• Maria Terminel
• Tmi Physical Therapy, Inc.
• Van Horn Youth Center
• Lindsey Van Liew, PA-C
• Cynthia Wakugawa
• West Coast Dental Group
• Wylie Center

• All providers in Nuevo, CA
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.

Verify at the official NPI Registry.