Individual provider Active NPI

Jennifer Ngoc Anh Bui, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Covina, CA
National Provider Identifier
1578003018
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
54225 Issued in CA
Practice address
500 W San Bernardino Rd Ste a
Covina, CA 91722-3797
Phone
(626) 966-1909
NPI assigned
Mar 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 54225 CA Primary

Addresses

Primary practice location

500 W San Bernardino Rd Ste a
Covina, CA 91722-3797

Mailing address

16228 Palomino Mesa PL
San Diego, CA 92127-4446
Phone (858) 408-5662

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
54225CAMDPharmacist

Interoperability endpoints

  • Direct secure messaging: jenniferbui@skmm.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1578003018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16228 PALOMINO MESA PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921274446",
            "telephone_number": "858-408-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W SAN BERNARDINO RD STE A",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223797",
            "telephone_number": "626-966-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUI",
        "first_name": "JENNIFER",
        "middle_name": "NGOC ANH",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "54225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.