Active NPI
Thanh-Tam Tiffany Huynh
- Physician Assistant
- Newport Beach, CA
National Provider Identifier
1164998803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 56040
- Practice address
- 355 Placentia Ave Ste 203
Newport Beach, CA 92663-3302 - Phone
- (949) 650-0616
- NPI assigned
- Oct 20, 2018
- Last updated
- Apr 24, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 56040 | CA | Primary |
Addresses
Primary practice location
355 Placentia Ave Ste 203
Newport Beach, CA 92663-3302
Mailing address
770 Magnolia Ave Ste 2a
Corona, CA 92879-3122
Phone (626) 548-9444
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230921001386 | CA | Order and Referring Only - Endocrinology | 9739533910 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56040 | CA | MD | Dentist |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JDCFCA/Endpoint/JDCFCA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682294400000",
"number": "1164998803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 MAGNOLIA AVE STE 2A",
"city": "CORONA",
"state": "CA",
"postal_code": "928793122",
"telephone_number": "626-548-9444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 PLACENTIA AVE STE 203",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926633302",
"telephone_number": "949-650-0616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUYNH",
"first_name": "THANH-TAM",
"middle_name": "TIFFANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-20",
"last_updated": "2023-04-24",
"certification_date": "2023-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "56040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.