Individual provider Active NPI

Jolie Ngo, CRNA

  • Certified Registered Nurse Anesthetist
  • San Diego, CA
National Provider Identifier
1063879583
Registry record updated Feb 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA95000830 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X COA.18668 OH
Certified Registered Nurse Anesthetist 367500000X RN281980 GA
Certified Registered Nurse Anesthetist 367500000X NA95000830 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other practice location 1

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (567) 585-1945

Other practice location 2

3747 Roswell Rd
Marietta, GA 30062-6215
Phone (770) 794-0477

Other practice location 3

2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone (770) 794-0477

Other practice location 4

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (770) 794-0477

Other practice location 5

146 Bill Carruth Pkwy
Hiram, GA 30141-3749
Phone (770) 794-0477

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210219002433 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597069898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Oakland College of Medicine and Surgery, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, shared by 18 NPIs, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-1911
Phone (858) 249-6753

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
NA95000830CAMDCertified Registered Nurse Anesthetist
RN281980GAMDCertified Registered Nurse Anesthetist
COA.18668OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jan 13, 2021 Accepting new patients
Regents of the University of California Nurse Anesthetist, Certified Registered CurrentSince Jan 13, 2021 Accepting new patients
Regents of the University of California CurrentSince Jan 13, 2021 Accepting new patients
Flower Hospital Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Promedica Central Physicians Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 7

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 1

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": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1063879583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2142 N Cove Blvd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436063895",
            "country_code": "US",
            "telephone_number": "567-585-1945",
            "fax_number": "419-824-7359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3747 Roswell Rd",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300626215",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2540 Windy Hill Rd SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678605",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8954 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301342272",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "146 Bill Carruth Pkwy",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301413749",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGO",
        "first_name": "JOLIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.18668",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN281980",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95000830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.