Individual provider Active NPI

Jennie Quach

  • Physician Assistant
  • Irvine, CA
National Provider Identifier
1467883207
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
51269 Issued in CA
Practice address
17305 Von Karman Ave Ste 101-107
Irvine, CA 92614-0963
Phone
(949) 679-9994
NPI assigned
Dec 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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 51269 CA Primary

Addresses

Primary practice location

17305 Von Karman Ave Ste 101-107
Irvine, CA 92614-0963

Mailing address

17305 Von Karman Ave Ste 107
Irvine, CA 92614-0903
Phone (949) 679-9994

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
I20140424001068 CA Practitioner - Physician Assistant 0547493710 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

2195 Sepulveda Blvd
Torrance, CA 90501-4616
Phone (424) 337-1600

2613 Pacific Coast Hwy
Torrance, CA 90505-7037
Phone (424) 625-0220

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

28900 S Western Ave
Rancho Palos Verdes, CA 90275-0805
Phone (424) 702-0500

5101 Lakewood Blvd
Lakewood, CA 90712-2413
Phone (562) 800-3883

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.12 of 100Reported as group
Quality
77.79
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Jul 1, 2015 Accepting new patients
Carbon Health Medical Group of California PC CurrentSince Sep 17, 2022 Accepting new patients
Front Line Emergency Care Spec Past Accepting new patients

Locations

7330 El Camino Real
Atascadero, CA 93422
Phone (805) 703-2501

4700 W Pico Blvd
Ste Gh
Los Angeles, CA 90019
Phone (323) 673-7031

3630 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 900-7420

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

806 New Los Angeles Ave
Moorpark, CA 93021
Phone (805) 334-8650

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

Organizations & group practices 12

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 2

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": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1467883207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17305 VON KARMAN AVE STE 107",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926140903",
            "telephone_number": "949-679-9994",
            "fax_number": "949-679-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17305 VON KARMAN AVE STE 101-107",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926140963",
            "telephone_number": "949-679-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUACH",
        "first_name": "JENNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-04",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.