Individual provider Active NPI

Ngoc Nguyen, PA

  • Physician Assistant
  • Marina del Rey, CA
National Provider Identifier
1730960758
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65456 Issued in CA
Practice address
4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone
(310) 823-8991
Fax
(310) 577-5694
NPI assigned
Oct 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA65456 CA Primary

Addresses

Primary practice location

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513

Other practice location 1

530 S Jackson St
Louisville, KY 40202-1675
Phone (502) 562-4429

Other practice location 2

200 Abraham Flexner Way Ste 1
Louisville, KY 40202-1886
Phone (502) 562-4429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231206002536 KY Practitioner - Physician Assistant 3577912260 Reassigns benefits to 1 organization
I20250403002106 CA Practitioner - Physician Assistant 3577912260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Phone (310) 823-8911

8635 W 3Rd St
Suite 465W
Los Angeles, CA 90048-6111
Phone (310) 423-0674

Hospital & facility affiliations

  • Cedar-Sinai Marina del Rey Hospital Hospital, Marina del Rey, CA, CCN 050740

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65456CAMDPharmacist
PA65456CAMDPhysician Assistant
TC072KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Mar 1, 2025 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

116 N Robertson Blvd
Ste 500
Los Angeles, CA 90048
Phone (310) 423-1440

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

4650 Lincoln Blvd
Venice, CA 90292
Phone (310) 577-5505

7752 Solution Ctr
Chicago, IL 60677

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

200 Abraham Flexner Way
Ste 1
Louisville, KY 40202
Phone (502) 210-4200

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Organizations & group practices 5

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 1

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": "1696550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1730960758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 LINCOLN BLVD",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926306",
            "telephone_number": "310-823-8991",
            "fax_number": "310-577-5694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021675",
            "country_code": "US",
            "telephone_number": "502-562-4429",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Abraham Flexner Way Ste 1",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021886",
            "country_code": "US",
            "telephone_number": "502-562-4429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NGOC",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-06",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

Verify at the official NPI Registry.