Active NPI
Taija Bjorgo
- Physician Assistant
- Burbank, CA
National Provider Identifier
1679298723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA64288
- Practice address
- 2501 W Burbank Blvd
Burbank, CA 91505-2347 - Phone
- (818) 856-9535
- NPI assigned
- Oct 11, 2022
- Last updated
- Apr 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA64288 | CA | Primary |
| Medical Physician Assistant | 363AM0700X | NU | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
2501 W Burbank Blvd
Burbank, CA 91505-2347
Mailing address
2501 W Burbank Blvd
Burbank, CA 91505-2347
Phone (818) 856-9535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2300 Fall Hill Ave
Suite 215
Fredericksburg, VA 22401-3342
Phone (877) 290-1478
492 Elma G Miles Pkwy
Hinesville, GA 31313-4000
Phone (912) 369-9513
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA64288 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hyperbaric & Woundcare Inc | Current | Accepting new patients | |
| Charles Drew University of Medicine & Science | Past | Accepting new patients |
Locations
163 S Tallahassee St
Hazlehurst, GA 31539
Phone (912) 375-7781
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Hazlehurst, GA
- NPI 1780105296
-
- Family Medicine Physician
- Fredericksburg, VA
- NPI 1811726698
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Los Angeles, CA
- NPI 1609367788
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Liberty Regional Medical Center
- Critical Access Hospital
- Hinesville, GA
- NPI 1326079260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1679298723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 W BURBANK BLVD",
"city": "BURBANK",
"state": "CA",
"postal_code": "915052347",
"telephone_number": "818-856-9535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 W BURBANK BLVD",
"city": "BURBANK",
"state": "CA",
"postal_code": "915052347",
"telephone_number": "818-856-9535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BJORGO",
"first_name": "TAIJA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-11",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA64288",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.