Individual provider Active NPI

Ivy Wei Chow, PA-C

  • Physician Assistant
  • Chino Hills, CA
National Provider Identifier
1235533670
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
51990 Issued in CA
Practice address
13089 Peyton Dr # C468
Chino Hills, CA 91709-6018
Phone
(909) 865-9500
NPI assigned
Oct 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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 51990 CA Primary

Addresses

Primary practice location

13089 Peyton Dr # C468
Chino Hills, CA 91709-6018

Mailing address

13089 Peyton Dr # C468
Chino Hills, CA 91709-6018
Phone (909) 865-9500

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20150116001761 CA Practitioner - Physician Assistant 0648594853 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
51990CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 21, 2020 Accepting new patients
Cep America - California CurrentSince Nov 15, 2014 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 21, 2020 Accepting new patients
Premier Emergency Physicians of California Medical Group PC Physician Assistant Past Accepting new patients
Rainbow Basin Emergency Physicians, a Medical Corporation Physician Assistant Past Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

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

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

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": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1235533670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13089 PEYTON DR # C468",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096018",
            "telephone_number": "909-865-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13089 PEYTON DR # C468",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096018",
            "telephone_number": "909-865-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOW",
        "first_name": "IVY",
        "middle_name": "WEI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.