Individual provider Active NPI

Paul Sangwook Rhee, MS, PA-C

  • Physician Assistant
  • Apple Valley, CA
National Provider Identifier
1194253377
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA54854 Issued in CA
Practice address
18300 US Highway 18
Apple Valley, CA 92307-2206
Phone
(760) 242-2311
NPI assigned
May 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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 PA54854 CA Primary

Addresses

Primary practice location

18300 US Highway 18
Apple Valley, CA 92307-2206

Mailing address

2060 Tierra Loma Dr
Diamond Bar, CA 91765-3135

Other practice location 1

2060 Tierra Loma Dr
Diamond Bar, CA 91765-3135
Phone (909) 518-2588

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
I20171107000808 CA Practitioner - Physician Assistant 9931465085 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA54854CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Urgent Care Group, Inc CurrentSince Jan 10, 2025 Accepting new patients
Cep America - California CurrentSince Aug 1, 2018 Accepting new patients
Cep America-California CurrentSince Oct 1, 2017 Accepting new patients

Locations

12442 Limonite Ave
Unit 102
Eastvale, CA 91752
Phone (951) 393-3000

16465 Sierra Lakes Pkwy
Ste 100
Fontana, CA 92336
Phone (909) 434-1150

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

Organizations & group practices 7

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": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1194253377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 TIERRA LOMA DR",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072206",
            "telephone_number": "760-242-2311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2060 Tierra Loma Dr",
            "address_purpose": "LOCATION",
            "city": "Diamond Bar",
            "state": "CA",
            "postal_code": "917653135",
            "country_code": "US",
            "telephone_number": "909-518-2588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RHEE",
        "first_name": "PAUL",
        "middle_name": "SANGWOOK",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA54854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.