Individual provider Active NPI

Arissa Katie Ma, MD

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1568090587
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A186383 Issued in CA
Practice address
3900 E Pacific Coast Hwy
Long Beach, CA 90804-2013
Phone
(877) 574-2273
NPI assigned
Mar 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PTL4161 CA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A186383 CA Primary

Addresses

Primary practice location

3900 E Pacific Coast Hwy
Long Beach, CA 90804-2013

Mailing address

3900 E Pacific Coast Hwy
Long Beach, CA 90804-2013
Phone (877) 574-2273

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20240312002932 CA Practitioner - Family Practice 3779996046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

25821 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

25825 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

3900 E Pacific Coast Hwy
Long Beach, CA 90804-2013
Phone (562) 986-2200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A186383CAMDFamily Medicine Physician
PTL4161CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 16, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 16, 2024 Accepting new patients

Locations

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

3900 E Pacific Coast Hwy
Long Beach, CA 90804
Phone (310) 325-5111

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

Organizations & group practices 3

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1568090587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E PACIFIC COAST HWY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042013",
            "telephone_number": "877-574-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 E PACIFIC COAST HWY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042013",
            "telephone_number": "877-574-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "ARISSA",
        "middle_name": "KATIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PTL4161",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A186383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.