Individual provider Active NPI

Roger Ngaha, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Beaumont, CA
National Provider Identifier
1134869886
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95020236 Issued in CA
Practice address
1497 Hunter Moon Way
Beaumont, CA 92223-2068
Phone
(562) 787-5570
NPI assigned
Mar 30, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0808X 95020236 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95020236 CA Primary

Addresses

Primary practice location

1497 Hunter Moon Way
Beaumont, CA 92223-2068

Mailing address

1497 Hunter Moon Way
Beaumont, CA 92223-2068
Phone (562) 787-5570

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
I20220526002446 CA Practitioner - Nurse Practitioner 6901284298 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Community Health CenterGroup PAC ID 7810394756, 29 clinicians

Practice addresses (Care Compare)

520 N Main St
Suite 120
Santa Ana, CA 92701-4623
Phone (714) 352-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Foundation Medical Inc. Single Specialty CurrentSince May 1, 2022 Accepting new patients
Access Community Health Center Single Specialty CurrentSince Oct 22, 2023 Accepting new patients
Access Community Health Center Past Accepting new patients

Locations

24953 Paseo de Valencia
Ste 7C
Laguna Hills, CA 92653
Phone (714) 352-5800

6960 Magnolia Ave
Ste 203
Riverside, CA 92506
Phone (714) 352-5800

520 N Main St
Ste 220
Santa Ana, CA 92701
Phone (714) 352-5800

520 N Main St
Ste 120
Santa Ana, CA 92701
Phone (714) 352-5800

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1134869886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1497 HUNTER MOON WAY",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922232068",
            "telephone_number": "562-787-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 HUNTER MOON WAY",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922232068",
            "telephone_number": "562-787-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGAHA",
        "first_name": "ROGER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95020236",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95020236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, CA

Sources for this page

Verify at the official NPI Registry.