Individual provider Active NPI

Tamara O'Nan, PA-C

  • Physician Assistant
  • Newport Beach, CA
National Provider Identifier
1477837862
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21869 Issued in CA
Practice address
1401 Dove St Ste 420
Newport Beach, CA 92660-2420
Phone
(949) 945-0927
Fax
(949) 269-6263
NPI assigned
Oct 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA21869 CA
Physician Assistant 363A00000X PA21869 CA Primary

Addresses

Primary practice location

1401 Dove St Ste 420
Newport Beach, CA 92660-2420

Mailing address

PO Box 3699
Newport Beach, CA 92659-8699
Phone (657) 241-3600

Other practice location 1

1190 W. Baker St
Ste 100
Costa Mesa, CA 92626-4105
Phone (714) 668-2500

Other identifiers 1

IdentifierTypeStateIssuer
P01199945OtherCAMEDICARE RAILROAD

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
I20120405000305 CA Practitioner - Physician Assistant 6103091871 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21869CAMDProfessional Counselor
PA21869CAMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1477837862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3699",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926598699",
            "telephone_number": "657-241-3600",
            "fax_number": "657-241-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 DOVE ST STE 420",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602420",
            "telephone_number": "949-945-0927",
            "fax_number": "949-269-6263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1190 W. Baker St",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926264105",
            "country_code": "US",
            "telephone_number": "714-668-2500",
            "fax_number": "714-668-2515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NAN",
        "first_name": "TAMARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21869",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01199945",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.