Kristina Thanh Nguyen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA64640 Issued in CA

Practice address

1115 S Sunset Ave
West Covina, CA 91790-3940

Phone

(626) 962-4011

NPI assigned

Dec 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Exer Medical Corporation

  • Urgent Care Clinic/Center
  • Calabasas, CA
  • NPI 1588901532
  Medicare reassignment Care Compare group
• Cep America - California

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843
  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Montebello, CA
  • NPI 1396971651
  NPD
• Baldwin Wallace University

  • Student Health Clinic/Center
  • Berea, OH
  • NPI 1730157272
  NPD (past)

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1831802552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "91790",
            "telephone_number": "626-962-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903940",
            "telephone_number": "626-962-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Eastland Rd",
            "address_purpose": "LOCATION",
            "city": "Berea",
            "state": "OH",
            "postal_code": "440172005",
            "country_code": "US",
            "telephone_number": "440-826-8012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KRISTINA",
        "middle_name": "THANH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2024-07-18",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA64640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huy Tu Nguyen, D.O.
• Jarvis Nguyen
• Jennifer T Nguyen
• Jenny Nguyen, DO
• Jessica Nguyen
• Linh-CHI Nguyen
• Lisa Nguyen
• Marie Nguyen
• Michelle Nguyen, DDS
• Nhi Nguyen, BCBA

• Medical Physician Assistant in West Covina, CA
• Providers in West Covina, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.

Verify at the official NPI Registry.