Individual provider Active NPI

Powen Hsueh, D.O.

  • General Practice Physician
  • La Quinta, CA
National Provider Identifier
1801280953
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20A18688 Issued in CA
Practice address
79430 Highway 111 Ste 102
La Quinta, CA 92253-4549
Phone
(951) 827-7793
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34016727 OH
General Practice Physician 208D00000X 1614 NE
Hospitalist Physician 208M00000X 34016727 OH
General Practice Physician 208D00000X 20A18688 CA Primary

Addresses

Primary practice location

79430 Highway 111 Ste 102
La Quinta, CA 92253-4549

Mailing address

79430 Highway 111 Ste 102
La Quinta, CA 92253-4549
Phone (951) 827-7793

Other practice location 1

335 Glessner Ave
Mansfield, OH 44903-2269
Phone (419) 526-8581

Other identifiers 1

IdentifierTypeStateIssuer
0022352MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821000387 OH Practitioner - HospitalistPractitioner - Pediatric Medicine 7911369178 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1614NEMDMental Health Counselor
20A18688CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Academic Association, Inc. Pediatrics CurrentSince Aug 15, 2023 Accepting new patients
Regents of the University of California Past Accepting new patients
Pediatrix Medical Group of California, a Professional Corporation Pediatrics Past Accepting new patients
Valley Children'S Medical Group Pediatrics Past Accepting new patients

Locations

Dept L289
Columbus, OH 43260

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

Interoperability endpoints

  • Direct secure messaging: phsueh686175@hisp.ehr.sutterhealth.org
  • Direct secure messaging: powen.hsueh.1@22027.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.

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1801280953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79430 HIGHWAY 111 STE 102",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534549",
            "telephone_number": "951-827-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79430 HIGHWAY 111 STE 102",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534549",
            "telephone_number": "951-827-7793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 Glessner Ave",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449032269",
            "country_code": "US",
            "telephone_number": "419-526-8581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HSUEH",
        "first_name": "POWEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34016727",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "1614",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "34016727",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A18688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0022352",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Quinta, CA

Sources for this page

Verify at the official NPI Registry.