Individual provider Active NPI

Jennifer Ngo, FNP-BC

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1174300875
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95026842 Issued in CA
Practice address
1040 Elm Ave Ste 302
Long Beach, CA 90813-3267
Phone
(562) 495-4952
NPI assigned
Sep 14, 2023
Last updated
Sep 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95026842 CA Primary

Addresses

Primary practice location

1040 Elm Ave Ste 302
Long Beach, CA 90813-3267

Mailing address

1040 Elm Ave Ste 302
Long Beach, CA 90813-3267

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
I20231027000315 CA Practitioner - Nurse Practitioner 8325494313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1040 Elm Ave
Suite 302
Long Beach, CA 90813-3267
Phone (562) 495-4952

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95026842CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Current Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Oct 15, 2023 Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Oct 15, 2023 Accepting new patients
Prohealth Partners, a Medical Group, Inc. Past Accepting new patients

Locations

1040 Elm Ave
Ste 302
Long Beach, CA 90813
Phone (562) 495-4952

1045 Atlantic Ave
Ste 505
Long Beach, CA 90813
Phone (562) 437-0996

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1174300875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 ELM AVE STE 302",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 ELM AVE STE 302",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133267",
            "telephone_number": "562-495-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "JENNIFER",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95026842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.