Individual provider Active NPI

Yaw O Asamoah, PA-C

  • Physician Assistant
  • Fontana, CA
National Provider Identifier
1083917439
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20953 Issued in CA
Practice address
6309 Camelback LN
Fontana, CA 92336-5830
Phone
(213) 804-9776
NPI assigned
Dec 7, 2010
Last updated
May 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2018

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 PA20953 CA Primary

Addresses

Primary practice location

6309 Camelback LN
Fontana, CA 92336-5830

Mailing address

PO Box 4570
Palos Verdes Peninsula, CA 90274-9607
Phone (424) 400-7748

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
I20111130000645 CA Practitioner - Physician Assistant 2961676978 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
68.08 of 100Reported as group
Quality
5.65
Promoting interoperability
92
Improvement activities
40
Cost
61.28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA20953CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skilled Facility Health Care Solutions Inc CurrentSince Sep 27, 2011 Accepting new patients
Chaparral Medical Group Inc. CurrentSince Feb 20, 1992 Accepting new patients
Mission City Community Network, Inc. CurrentSince Sep 21, 2022 Accepting new patients
Chaparral Medical Group, Inc. CurrentSince Feb 20, 1992 Accepting new patients
BGM Medical Services Inc a Medical Corporation Past Accepting new patients

Locations

11614 183rd St
Artesia, CA 90701
Phone (562) 865-5218

875 N Brea Blvd
Brea, CA 92821
Phone (714) 529-6842

3746 Foothill Blvd
La Crescenta, CA 91214
Phone (323) 574-0387

12021 Wilshire Blvd
Los Angeles, CA 90025
Phone (310) 348-1900

8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone 8188953100602

1300 N C St
Oxnard, CA 93030
Phone (805) 983-0305

1801 W Olympic Blvd
Pasadena, CA 91199

1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767
Phone (909) 623-8796

9190 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 581-6732

3880 Via Lucero
Santa Barbara, CA 93110
Phone (805) 687-6651

1340 15th St
Santa Monica, CA 90404
Phone (310) 451-9700

15206 Parthenia St
Sepulveda, CA 91343

250 Fairview Rd
Thousand Oaks, CA 91361
Phone (707) 964-6333

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Organizations & group practices 9

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": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1083917439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4570",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902749607",
            "telephone_number": "424-400-7748",
            "fax_number": "424-400-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 CAMELBACK LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365830",
            "telephone_number": "213-804-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASAMOAH",
        "first_name": "YAW",
        "middle_name": "O",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-07",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.