Organization Active NPI

Binh T. Ngo, Dermatology, P.C.

  • Dermatology Physician
  • Newport Beach, CA
National Provider Identifier
1053783704
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A89405 Issued in CA
Legal business name
BINH T. NGO, DERMATOLOGY, P.C.
Practice address
355 Placentia Ave
Suite 308
Newport Beach, CA 92663-3311
Phone
(213) 804-9778
Fax
(888) 379-3667
NPI assigned
Oct 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Authorized official

Name
Dr. Binh T Ngo, M.D.NPI 1083812770
Title
President
Phone
(213) 804-9778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X A89405 CA Primary

Addresses

Primary practice location

355 Placentia Ave
Suite 308
Newport Beach, CA 92663-3311

Mailing address

34 Versailles
Newport Coast, CA 92657
Phone (213) 804-9778

Other names 1

  • Faculty Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160318001490 CA Part B Supplier - Clinic/Group Practice 6103123161 Receives reassigned benefits from 1 practitioner
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1053783704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 VERSAILLES",
            "city": "NEWPORT COAST",
            "state": "CA",
            "postal_code": "92657",
            "telephone_number": "213-804-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 PLACENTIA AVE",
            "address_2": "SUITE 308",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633311",
            "telephone_number": "213-804-9778",
            "fax_number": "888-379-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BINH T. NGO, DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "BINH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-804-9778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A89405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Faculty Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.