Individual provider Active NPI

Mai Phuong Ngo, M.D.

  • Pediatric Rehabilitation Medicine Physician
  • San Diego, CA
National Provider Identifier
1508910787
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
License
A90185 Issued in CA
Practice address
7910 Frost St
San Diego, CA 92123-2771
Phone
(858) 966-8974
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A90185 CA
Physical Medicine & Rehabilitation Physician 208100000X A90185 CA
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician 2081P0301X A90185 CA
Pediatric Rehabilitation Medicine Physician 2081P0010X A90185 CA Primary

Addresses

Primary practice location

7910 Frost St
San Diego, CA 92123-2771

Mailing address

3020 Childrens Way
San Diego, CA 92123-4223
Phone (858) 309-6300

Other practice location 1

747 52nd St
Oakland, CA 94609-1809
Phone (510) 428-3885

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121130000355 CA Practitioner - Physical Medicine and RehabilitationPractitioner - Pediatric Medicine 6709038532 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Nov 15, 2019 Accepting new patients
University of California San Francisco Pediatrics CurrentSince Nov 15, 2019 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 15, 2019 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Nov 15, 2019 Accepting new patients
University of California San Francisco CurrentSince Nov 15, 2019 Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients
Children'S Hospital & Research Center at Oakland Past Accepting new patients
University of California San Francisco Past Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

747 52nd St
Rm 203
Oakland, CA 94609

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1508910787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 FROST ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232771",
            "telephone_number": "858-966-8974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 52nd St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946091809",
            "country_code": "US",
            "telephone_number": "510-428-3885",
            "fax_number": "510-450-5821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGO",
        "first_name": "MAI",
        "middle_name": "PHUONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A90185",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A90185",
            "primary": false
        },
        {
            "code": "2081P0301X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": "CA",
            "license": "A90185",
            "primary": false
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "CA",
            "license": "A90185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.