Individual provider Active NPI

Justine Liao Huang, PA-C

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1609402148
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA57900 Issued in CA
Practice address
2725 Pacific Ave
Long Beach, CA 90806-2612
Phone
(949) 371-9773
NPI assigned
Mar 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA57900 CA Primary

Addresses

Primary practice location

2725 Pacific Ave
Long Beach, CA 90806-2612

Mailing address

6130 Paisley St
Houston, TX 77096-3725
Phone (713) 732-0677

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
I20200928001281 CA Practitioner - Physician Assistant 6204255169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

20911 Earl St
Suite 140
Torrance, CA 90503-4353
Phone (310) 542-0199

23600 Telo Ave
Suite 220
Torrance, CA 90505-4039
Phone (310) 534-8400

9850 Genesee Ave
Suite 440
La Jolla, CA 92037-1212
Phone (858) 453-5944

Hospital & facility affiliations

  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351
  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA57900CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Urology Current Accepting new patients
Urology Institute of the South Bay Current Accepting new patients

Locations

23600 Telo Ave
Ste 220
Torrance, CA 90505
Phone (310) 534-8400

20911 Earl St
Ste 140
Torrance, CA 90503
Phone (310) 542-0199

Interoperability endpoints

  • Direct secure messaging: justine.huang.1@3663.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1609402148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 PAISLEY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770963725",
            "telephone_number": "713-732-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062612",
            "telephone_number": "949-371-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "JUSTINE",
        "middle_name": "LIAO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.