Nan Jiang, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA09643 Issued in TX

Practice address

1555 S Garey Ave
Pomona, CA 91766-5222

Phone

(909) 620-8088

Fax

(909) 623-9648

NPI assigned

Mar 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

University of Texas Southwestern Medical School at Dallas, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Valley Community Health Center, Inc.Group PAC ID 9234041765, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: nan.jiang.p1@direct.evchc.nextgenshare.com

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.

• East Valley Community Health Center, Inc.

  dba East Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • West Covina, CA
  • NPI 1831243625
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1528451812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 S GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665222",
            "telephone_number": "909-620-8088",
            "fax_number": "909-623-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 S GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665222",
            "telephone_number": "909-620-8088",
            "fax_number": "909-623-9648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16901 Dallas Pkwy",
            "address_2": "Suite 208",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "TX",
            "postal_code": "750015226",
            "country_code": "US",
            "telephone_number": "972-248-2020",
            "fax_number": "972-248-2028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIANG",
        "first_name": "NAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA54434",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA09643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joellesa Catherine Jerido
• Jerry Kim MD Inc
• Jesse Woo MD Inc (Comprehensive OBGYN Care)
• Telicia Kay Jett, MS, LMFT
• Kelly Jiang
• Xiangxiang Jiang
• Samanta Jimenez Calmo
• Eva Cristina Jimenez Morones
• Alexandra Jimenez
• Andrea Michelle Jimenez

• Medical Physician Assistant in Pomona, CA
• Providers in Pomona, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.