Individual provider Active NPI

Julie Kim Ahn, PA-C

  • Physician Assistant
  • Corona, CA
National Provider Identifier
1346802543
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56992 Issued in CA
Practice address
800 S Main St
Corona, CA 92882-3420
Phone
(951) 737-4343
NPI assigned
Jul 8, 2019
Last updated
Jul 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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 56992 CA Primary

Addresses

Primary practice location

800 S Main St
Corona, CA 92882-3420

Mailing address

435 Garfield Ave Apt 105
South Pasadena, CA 91030-2238
Phone (626) 773-1296

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
I20191114002507 CA Practitioner - Physician Assistant 5193157006 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Viejo Emergency Medical Associates, Inc.Group PAC ID 7315090271, 28 clinicians

Practice addresses (Care Compare)

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone (310) 118-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.35 of 100Reported as group
Quality
81.59
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56992CAMDPharmacist

Interoperability endpoints

  • Direct secure messaging: jahn1272375@direct.uclahealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1346802543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 GARFIELD AVE APT 105",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302238",
            "telephone_number": "626-773-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S MAIN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823420",
            "telephone_number": "951-737-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "JULIE",
        "middle_name": "KIM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.