Individual provider Active NPI

Christine Luong, PA-C

  • Physician Assistant
  • Lighthouse Point, FL
National Provider Identifier
1548053762
Registry record updated Aug 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9120264 Issued in FL
Practice address
5340 N Federal Hwy Ste 110
Lighthouse Point, FL 33064-7058
Phone
(954) 428-2480
NPI assigned
May 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA9120264 FL Primary

Addresses

Primary practice location

5340 N Federal Hwy Ste 110
Lighthouse Point, FL 33064-7058

Mailing address

5340 N Federal Hwy Ste 110
Lighthouse Point, FL 33064-7058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA9120264FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premium Practice Solutions, LLC Single Specialty CurrentSince Jun 3, 2025 Accepting new patients
Lighthouse Foot & Ankle Center Single Specialty PastSince Jun 3, 2025 Accepting new patients

Locations

5340 N Federal Hwy
Ste 110
Lighthouse Point, FL 33064
Phone (954) 428-2480

Organizations & group practices 2

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": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754092800000",
    "number": "1548053762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 N FEDERAL HWY STE 110",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 N FEDERAL HWY STE 110",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647058",
            "telephone_number": "954-428-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONG",
        "first_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-08-02",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9120264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lighthouse Point, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.