Individual provider Active NPI

Lauren Nicole Dewiggins, PA-C

  • Physician Assistant
  • Los Alamitos, CA
National Provider Identifier
1043997257
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65496 Issued in CA
Practice address
3851 Katella Ave Ste 202
Los Alamitos, CA 90720-3497
Phone
(562) 206-0177
NPI assigned
Jun 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA65496 CA Primary

Addresses

Primary practice location

3851 Katella Ave Ste 202
Los Alamitos, CA 90720-3497

Mailing address

3851 Katella Ave Ste 202
Los Alamitos, CA 90720-3497
Phone (562) 206-0177

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
I20250618001482 CA Practitioner - Physician Assistant 5799296570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beach Orthopaedic Specialty Institute IncGroup PAC ID 1658655261, 6 clinicians

Practice addresses (Care Compare)

3851 Katella Ave
Suite 202
Los Alamitos, CA 90720-3497
Phone (562) 206-0177

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA65496CAMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1043997257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 KATELLA AVE STE 202",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203497",
            "telephone_number": "562-206-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 KATELLA AVE STE 202",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203497",
            "telephone_number": "562-206-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWIGGINS",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.