Individual provider Active NPI

Nicole Yu, PA-C

  • Physician Assistant
  • Newport Beach, CA
National Provider Identifier
1508682626
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65347 Issued in CA
Practice address
1 Hoag Dr
Newport Beach, CA 92663-4162
Phone
(949) 764-5780
NPI assigned
Nov 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 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 PA65347 CA Primary

Addresses

Primary practice location

1 Hoag Dr
Newport Beach, CA 92663-4162

Mailing address

1 Hoag Dr
Newport Beach, CA 92663-4162
Phone (949) 764-5780

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
I20250513000828 CA Practitioner - Physician Assistant 9335667435 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA65347CAMDPhysician 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": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1508682626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-764-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-764-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.