Individual provider Active NPI

Alyxis Mah, PA-C

  • Physician Assistant
  • Fountain Valley, CA
National Provider Identifier
1861016685
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57969 Issued in CA
Practice address
11190 Warner Ave Ste 300
Fountain Valley, CA 92708-4045
Phone
(714) 241-7000
NPI assigned
Jun 8, 2020
Last updated
Oct 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57969 CA Primary

Addresses

Primary practice location

11190 Warner Ave Ste 300
Fountain Valley, CA 92708-4045

Mailing address

11190 Warner Ave Ste 300
Fountain Valley, CA 92708-4045
Phone (714) 241-7000

Other practice location 1

800 E Washington Blvd
Crescent City, CA 95531-8359
Phone (707) 464-8511

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200817001343 CA Practitioner - Physician Assistant 7618393026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christopher C Ninh MD, IncGroup PAC ID 6800954736, 5 clinicians

Practice addresses (Care Compare)

15191 Beach Blvd
Westminster, CA 92683-6203
Phone (714) 432-9990

17305 Von Karman Ave
Suite 100
Irvine, CA 92614-0903
Phone (714) 432-9990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57969CAMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1861016685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11190 WARNER AVE STE 300",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084045",
            "telephone_number": "714-241-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11190 WARNER AVE STE 300",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084045",
            "telephone_number": "714-241-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Crescent City",
            "state": "CA",
            "postal_code": "955318359",
            "country_code": "US",
            "telephone_number": "707-464-8511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAH",
        "first_name": "ALYXIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.