Individual provider Active NPI

Nina Ngo, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1477212777
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA062763 Issued in PA
Practice address
700 Cottman Ave
Philadelphia, PA 19111-3062
Phone
(215) 742-9900
Fax
(215) 742-7051
NPI assigned
Dec 14, 2021
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00663200 NJ
Medical Physician Assistant 363AM0700X MA062763 PA Primary

Addresses

Primary practice location

700 Cottman Ave
Philadelphia, PA 19111-3062

Mailing address

129 Friendship Rd
Drexel Hill, PA 19026-5008
Phone (610) 955-3027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220105000548 PA Practitioner - Physician Assistant 8628469467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5401 Old York Rd
Philadelphia, PA 19141-3030
Phone (215) 456-3930

5401 Old York Rd Klein BLDG
Phila, PA 19141-3030

5501 Old York Rd
Phila, PA 19141-3018

5501 Old York Rd Levy 2
Einstein Pediatrics Associates
Philadelphia, PA 19141-3018
Phone (215) 456-6786

5501 Old York Rd WCB 4TH FLR
Einstein CT Surgery Assoc
Philadelphia, PA 19141-3018
Phone (215) 456-8270

700 Cottman Ave
Philadelphia, PA 19111-3062

700 Cottman Ave B
Philadelphia, PA 19111-3062
Phone (215) 342-2100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00663200NJMDMedical Physician Assistant
MA062763PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Jul 15, 2022 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jul 15, 2022 Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

5401 Old York Rd
#B
Philadelphia, PA 19141
Phone (215) 324-3399

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

700 Cottman Ave
Ste 201
Philadelphia, PA 19111
Phone (215) 742-8123

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1477212777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 FRIENDSHIP RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190265008",
            "telephone_number": "610-955-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113062",
            "telephone_number": "215-742-9900",
            "fax_number": "215-742-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "NINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00663200",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA062763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.