Individual provider Active NPI

Jordan Louie Ahn

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1043903552
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3900 5TH Ave Ste 110
San Diego, CA 92103-3122
Phone
(858) 554-1212
NPI assigned
May 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary

Addresses

Primary practice location

3900 5TH Ave Ste 110
San Diego, CA 92103-3122

Mailing address

3900 5TH Ave Ste 110
San Diego, CA 92103-3122
Phone (858) 554-1212

Other practice location 1

7855 Ivanhoe Ave Ste 110
LA Jolla, CA 92037-4507
Phone (858) 554-1212

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231012001007 CA Practitioner - Physician Assistant 5799130654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monica Perlman MD Inc 357 clinicians

Practice addresses (Care Compare)

3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855

3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212

477 N El Camino Real
Suite A200
Encinitas, CA 92024-1350
Phone (858) 766-6007

7855 Ivanhoe Ave
Suite 110
La Jolla, CA 92037-4507
Phone (858) 869-0188

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
63398CAMDDentist

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Regents of the University of California Past Accepting new patients
Planned Parenthood of the Pacific Southwest Past Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1043903552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 5TH AVE STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033122",
            "telephone_number": "858-554-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 5TH AVE STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033122",
            "telephone_number": "858-554-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7855 Ivanhoe Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920374507",
            "country_code": "US",
            "telephone_number": "858-554-1212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHN",
        "first_name": "JORDAN",
        "middle_name": "LOUIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.