Individual provider Active NPI

Son Huynh, PA-C

  • Surgical Physician Assistant
  • Fountain Valley, CA
National Provider Identifier
1588115141
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA53928 Issued in CA
Practice address
11160 Warner Ave Ste 311
Fountain Valley, CA 92708-4055
Phone
(714) 850-7300
NPI assigned
Oct 19, 2016
Last updated
Jan 16, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA53928 CA Primary

Addresses

Primary practice location

11160 Warner Ave Ste 311
Fountain Valley, CA 92708-4055

Mailing address

11160 Warner Ave Ste 311
Fountain Valley, CA 92708-4055

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170207000957 CA Practitioner - Physician Assistant 0749563203 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.03 of 100Reported as group
Quality
78.11
Improvement activities
40
Cost
33.57

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
53928CAMDDentist
PA53928CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Hope Podiatry Group Inc. PastSince Dec 29, 2024 Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1588115141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE STE 311",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE STE 311",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084055",
            "telephone_number": "714-850-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "SON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-19",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA53928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.