Individual provider Active NPI

Matthew NG, PA-C

  • Physician Assistant
  • Irvine, CA
National Provider Identifier
1417622655
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
18021 Sky Park Cir
Irvine, CA 92614-6523
Phone
(626) 373-0002
NPI assigned
Aug 10, 2021
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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 NU Primary

Addresses

Primary practice location

18021 Sky Park Cir
Irvine, CA 92614-6523

Mailing address

100 E Valencia Mesa Dr Ste 310
Fullerton, CA 92835-3800
Phone (714) 734-3120

Other practice location 1

100 E Valencia Mesa Dr Ste 310
Fullerton, CA 92835-3800
Phone (714) 734-3120

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
I20220602001715 CA Practitioner - Physician Assistant 1658759600 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
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

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

1140 W la Veta Ave
Suite 770
Orange, CA 92868-4229
Phone (714) 835-8715

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

253 S Diamond Bar Blvd
Diamond Bar, CA 91765-1606
Phone (909) 860-1144

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60083CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Dec 16, 2022 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Dec 16, 2022 Accepting new patients
Providence Medical Foundation CurrentSince Jun 24, 2024 Accepting new patients
Providence Medical Foundation CurrentSince Jun 24, 2024 Accepting new patients

Locations

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

100 E Valencia Mesa Dr
Ste 310
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1417622655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR STE 310",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353800",
            "telephone_number": "714-734-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18021 SKY PARK CIR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146523",
            "telephone_number": "626-373-0002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Valencia Mesa Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928353800",
            "country_code": "US",
            "telephone_number": "714-734-3120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NG",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-10",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.