Mia Violet Khin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60811 Issued in CA

Practice address

3400 W Ball Rd Ste 100B
Anaheim, CA 92804-3735

Phone

(833) 487-2582

NPI assigned

Feb 27, 2022

Last updated

Feb 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, CO, WY3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mia.khin.p1@direct.lakeside.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Exer Medical Corporation

  dba Exer Urgent Care

  • Urgent Care Clinic/Center
  • Calabasas, CA
  • NPI 1588901532
  Medicare reassignment Care Compare group NPD
• Gustavo Alva, M.D., a Professional Corporation

  • Psychiatry Physician
  • Costa Mesa, CA
  • NPI 1376884072
  Medicare reassignment
• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  Medicare reassignment
• Care United Medical Center of Laramie, LLC

  dba BestMed

  • Multi-Specialty Clinic/Center
  • Laramie, WY
  • NPI 1063720605

  CO

  Medicare reassignment
• Urgent Care Northern Colorado

  dba AFC Urgent Care

  • Urgent Care Clinic/Center
  • Fort Collins, CO
  • NPI 1154025104
  Medicare reassignment

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

{
    "created_epoch": "1645920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645920000000",
    "number": "1053067132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6531 W 84TH PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900452807",
            "telephone_number": "909-908-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W BALL RD STE 100B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043735",
            "telephone_number": "833-487-2582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHIN",
        "first_name": "MIA",
        "middle_name": "VIOLET",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-27",
        "last_updated": "2022-02-27",
        "certification_date": "2022-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahaveer P. Khemka, M.D
• Pankaj M Khemka, M.D.
• Jesse Khen
• Meyna Kheng
• Khine (Karen) K Khin, M.D.
• Thiri Khin, M.D
• Nafiseh Khodaparast
• Asianna Luong Khong
• Jeannette Khong
• Trisha Truc Khong, PHARM.D.

• Physician Assistant in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.