Individual provider Active NPI

Andrea Nguyen, PA-C

  • Physician Assistant
  • Irvine, CA
National Provider Identifier
1255615761
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
21886 Issued in CA
Practice address
17305 Von Karman Ave
Suite 107
Irvine, CA 92614-0963
Phone
(949) 679-9994
NPI assigned
Oct 3, 2011
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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 21886 CA Primary

Addresses

Primary practice location

17305 Von Karman Ave
Suite 107
Irvine, CA 92614-0963

Mailing address

17305 Von Karman Ave Ste 107
Irvine, CA 92614-0903
Phone (949) 679-9994

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
I20111229000394 CA Practitioner - Physician Assistant 8527234277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tien Q Nguyen IncGroup PAC ID 0547319402, 12 clinicians

Practice addresses (Care Compare)

17271 Brookhurst St
Fountain Valley, CA 92708-3701
Phone (714) 531-2966

17305 Von Karman Ave
Suite 107
Irvine, CA 92614-0903
Phone (949) 679-9997

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21886CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Best Center Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1255615761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17305 VON KARMAN AVE STE 107",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926140903",
            "telephone_number": "949-679-9994",
            "fax_number": "949-679-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17305 VON KARMAN AVE",
            "address_2": "SUITE 107",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926140963",
            "telephone_number": "949-679-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANDREA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "21886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.