Phong Kieu, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95019542 Issued in CA

Practice address

202 W Harvey Ave
Santa Ana, CA 92707-4420

Phone

(714) 507-8008

NPI assigned

Dec 25, 2021

Last updated

Dec 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jason Kieu Professional name

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

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oceanside Medical Group a Medical CorporationGroup PAC ID 9335311042, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Los Angeles Community Hospital Hospital, Los Angeles, CA, CCN 050663
• Garden Grove Hospital & Medical Center Hospital, Garden Grove, CA, CCN 050230
• Huntington Beach Hospital Hospital, Huntington Beach, CA, CCN 050526
• West Anaheim Medical Center Hospital, Anaheim, CA, CCN 050426

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Oceanside Medical Group, a Medical Corporation

  • Psychiatry Physician
  • Santa Monica, CA
  • NPI 1861770513
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alta Los Angeles Hospital, Inc

  dba Los Angeles Hospital

  • Skilled Nursing Facility
  • Los Angeles, CA
  • NPI 1114132685

  Hospital

  Care Compare affiliation
• Alta Los Angeles Hospitals, Inc.

  dba Los Angeles Comm Hosp, Norwalk Comm Hosp & LA Comm Hosp at Bellflower

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922001809
  Care Compare affiliation
• Prime Healthcare Anaheim, LLC

  dba West Anaheim Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1871501916
  Care Compare affiliation
• Prime Healthcare Huntington Beach, LLC

  • General Acute Care Hospital
  • Huntington Beach, CA
  • NPI 1083622120
  Care Compare affiliation
• Prime Healthcare Services - Garden Grove LLC

  dba Garden Grove Hospital & Medical Center

  • General Acute Care Hospital
  • Garden Grove, CA
  • NPI 1659538858
  Care Compare affiliation

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

{
    "created_epoch": "1640390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640390400000",
    "number": "1295495737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W HARVEY AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927074420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W HARVEY AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927074420",
            "telephone_number": "714-507-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEU",
        "first_name": "PHONG",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-25",
        "last_updated": "2021-12-25",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95019542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASON",
            "last_name": "KIEU",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Baljeet Khurana, M.D.
• Krishan Singh Khurana, MD
• Sneh Khurana, MD
• Kia Ramezani, DDS Inc.
• Dana C Kiesling
• Alice H Kim, LMFT
• Amanda Kim, PSY.D.
• Ann Kim, MSN, MPH, CNS
• Anna Kim, PA-C
• Anna Ula Kim, R.N., PHN

• Psychiatric/Mental Health Nurse Practitioner in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2021; 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.