NPIMap

Individual provider Active NPI

Andrew Thua Thang Ngo, MD

  • Family Medicine Physician
  • Brea, CA
National Provider Identifier
1356978944
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A184383 Issued in CA
Practice address
955 W Imperial Hwy Ste 200
Brea, CA 92821-3812
Phone
(714) 449-6900
NPI assigned
Mar 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A184383 CA Primary

Addresses

Primary practice location

955 W Imperial Hwy Ste 200
Brea, CA 92821-3812

Mailing address

955 W Imperial Hwy Ste 200
Brea, CA 92821-3812
Phone (714) 449-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230720003171 CA Practitioner - Family Practice 8022478106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

955 W Imperial Hwy
Brea, CA 92821-3812

955 W Imperial Hwy
Suite 110
Brea, CA 92821-3814
Phone (714) 449-6900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A184383CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Family Medicine CurrentSince Jul 3, 2023 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Family Medicine CurrentSince Jul 3, 2023 Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

955 W Imperial Hwy
Ste 200
Brea, CA 92821
Phone (714) 449-6900

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ango2914699@oc.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1356978944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W IMPERIAL HWY STE 200",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213812",
            "telephone_number": "714-449-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W IMPERIAL HWY STE 200",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213812",
            "telephone_number": "714-449-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "ANDREW",
        "middle_name": "THUA THANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A184383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

Verify at the official NPI Registry.