Jacqueline Qi, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

17612 17TH St Ste 101
Tustin, CA 92780-1962

Phone

(714) 243-5450

NPI assigned

Nov 11, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tony N Nakhla DO IncGroup PAC ID 3678600715, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.32 of 100Reported as group

Quality

70.64

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Tony N. Nakhla, D.O., Inc.

  • Dermatology Physician
  • Santa Ana, CA
  • NPI 1730411794
  Medicare reassignment Care Compare group
• Ana Cardenas Dermatology, a Professional Corporation

  • MOHS-Micrographic Surgery Physician
  • Bakersfield, CA
  • NPI 1114033842
  Medicare reassignment
• Laurie M. Woll, D.O., Dermatology, a Medical Corp

  • Specialist
  • Montclair, CA
  • NPI 1477740546
  Medicare reassignment
• Goretti Ho Taghva M D Inc

  • Ambulatory Surgical Clinic/Center
  • Newport Beach, CA
  • NPI 1770931529
  NPD (past)
• Tustin Urgent Care, Apc

  • Urgent Care Clinic/Center
  • Tustin, CA
  • NPI 1225407596
  NPD (past)

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1215539556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17612 17TH ST STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801962",
            "telephone_number": "714-243-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17612 17TH ST STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801962",
            "telephone_number": "714-243-5450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17271 Brookhurst St",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927083701",
            "country_code": "US",
            "telephone_number": "714-531-2966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QI",
        "first_name": "JACQUELINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvatore Puma, PA-C
• Sathya S. Purcell, L.AC., OTR
• Pure Nutrition, Inc.
• Homyra Purmul
• Emma Puszczykowski
• Dimitri Armano Quaglierini
• Quality of Life Healthcare Inc
• Brian Bernard Quebbemann, M.D.
• Conrado Olalia Quemuel, CRT
• Daniel Quezada

• Physician Assistant in Tustin, CA
• Providers in Tustin, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.