Jennie Ninh Xu, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA65227 Issued in CA

Practice address

2450 Goodstone St
San Diego, CA 92111-6234

Phone

(858) 216-6585

NPI assigned

Oct 21, 2024

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, CO, AZ, IL, NV, FL, NY7 enrollments

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 7

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smi Imaging LLCGroup PAC ID 3476696220, 380 clinicians

Howard Simon MD PLLCGroup PAC ID 7214369966, 61 clinicians

Health Diagnostics of California a Professional CorporationGroup PAC ID 4284621525, 176 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Health Diagnostics of California a Professional Corporation

  • Diagnostic Radiology Physician
  • Mountain View, CA
  • NPI 1104321959
  Medicare reassignment Care Compare group NPD
• Howard Simon MD PLLC

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1659930998

  CA

  Medicare reassignment Care Compare group NPD
• Smi Imaging, LLC

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1972004489

  CA, CO, NV

  Medicare reassignment Care Compare group NPD
• Simonmed Reno PLLC

  • Diagnostic Radiology Physician
  • Reno, NV
  • NPI 1306576145
  Medicare reassignment NPD
• Howard John Simon MD PC

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1932768934

  CA

  Medicare reassignment
• Simonmed Imaging Florida LLC

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1477830818

  CA

  Medicare reassignment
• Health Diagnostics of California a Professional Corporation

  • Diagnostic Radiology Physician
  • Laguna Hills, CA
  • NPI 1245861368
  NPD
• Smi Imaging LLC

  • Mobile Mammography Clinic/Center
  • Tempe, AZ
  • NPI 1609412642
  NPD
• Smi Imaging LLC

  • Diagnostic Radiology Physician
  • Las Vegas, NV
  • NPI 1740826627
  NPD
• Smi Imaging LLC

  • Diagnostic Radiology Physician
  • Denver, CO
  • NPI 1881230829
  NPD

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1356162440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 GOODSTONE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116234",
            "telephone_number": "858-216-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 GOODSTONE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921116234",
            "telephone_number": "858-216-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XU",
        "first_name": "JENNIE",
        "middle_name": "NINH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Xu, DO
• Gang Laura Xu, M.D.
• Garvey Xu, DO
• Ivy Cinderella Xu
• Jason Lou Xu, MD
• Marian Xu, M.D.
• Randi Xu
• Ryan Xu
• Xiangdong Xu, M.D., PH.D.
• Xuejie Xu

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.