Individual provider Active NPI

Success Ngwasiri Nchotu, PA

  • Physician Assistant
  • Hemet, CA
National Provider Identifier
1073157210
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA62606 Issued in CA
Practice address
1030 E Florida Ave
Hemet, CA 92543-4511
Phone
(833) 867-4642
NPI assigned
Oct 31, 2019
Last updated
Sep 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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 PA62606 CA Primary

Addresses

Primary practice location

1030 E Florida Ave
Hemet, CA 92543-4511

Mailing address

716 Fremont St
Norfolk, VA 23504-2417
Phone (757) 325-7598

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
I20240314003785 CA Practitioner - Physician Assistant 9739583535 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA62606CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince Jun 1, 2024 Accepting new patients
Neighborhood Healthcare CurrentSince Jun 1, 2024 Accepting new patients
Neighborhood Healthcare Past Accepting new patients
Bicycle Health Medical Group PA PastSince Dec 17, 2023 Accepting new patients
Neighborhood Healthcare PastSince Jan 1, 2021 Accepting new patients

Locations

855 E Madison Ave
El Cajon, CA 92020
Phone (619) 440-2751

215 S Hickory St
Escondido, CA 92025
Phone (619) 354-3833

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

425 N Date St
#0
Escondido, CA 92025

1030 E Florida Ave
Hemet, CA 92543
Phone (951) 216-6100

4371 Latham St
Ste 200
Riverside, CA 92501

41840 Enterprise Cir N
Temecula, CA 92590
Phone (951) 225-6400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1073157210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 FREMONT ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235042417",
            "telephone_number": "757-325-7598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434511",
            "telephone_number": "833-867-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NCHOTU",
        "first_name": "SUCCESS",
        "middle_name": "NGWASIRI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-31",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.