Active NPI
Melinda L Kwong, PA-C
- Physician Assistant
- La Jolla, CA
National Provider Identifier
1629750328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 63340
- Practice address
- 9850 Genesee Ave Ste 320
La Jolla, CA 92037-1208 - Phone
- (858) 554-1212
- NPI assigned
- Aug 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 63340 | CA | Primary |
Addresses
Primary practice location
9850 Genesee Ave Ste 320
La Jolla, CA 92037-1208
Mailing address
19671 Beach Blvd Ste 215
Huntington Beach, CA 92648-5903
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855
3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- melindak@pnsi-ca.direct.office.nextgen.com
Organizations & group practices 1
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": "1690934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736121600000",
"number": "1629750328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19671 BEACH BLVD STE 215",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926485903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9850 GENESEE AVE STE 320",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371208",
"telephone_number": "858-554-1212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWONG",
"first_name": "MELINDA",
"middle_name": "L",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-02",
"last_updated": "2025-01-06",
"certification_date": "2024-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "63340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.